Healthcare Provider Details

I. General information

NPI: 1013834829
Provider Name (Legal Business Name): MDF AUDUBON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 W MERCHANT ST STE A
AUDUBON NJ
08106-1424
US

IV. Provider business mailing address

16 W VINE ST
MILLVILLE NJ
08332-3823
US

V. Phone/Fax

Practice location:
  • Phone: 856-547-9151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: HOJIN KIM
Title or Position: OWNER
Credential: DMD
Phone: 240-271-2122