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General NPI Number Information
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NPI Number | 1104434380
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Entity Type | Individual
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Provider Name | JONGSEUK LIM DDS
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Gender | Male
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 2056 SUPERIOR DR NW
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City | ROCHESTER
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State | MN
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Zip | 55901-5024
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Country | US
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Telephone | 507-710-3616
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Fax |
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Provider Business Mailing Address
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Address Line | 2375 SUPERIOR LN NW
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City | ROCHESTER
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State | MN
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Zip | 55901-3314
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Country | US
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Telephone | 571-598-4021
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D14426
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D14426
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License Number State | MN
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