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General NPI Number Information
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NPI Number | 1255950226
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Entity Type | Organization
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Legal Business Name | EMERGENCY AND GENERAL DENTAL PLLC
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 04/10/2020
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Provider Practice Location Address
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Address Line | 425 MADISON AVE RM 1800
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City | NEW YORK
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State | NY
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Zip | 10017-1152
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Country | US
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Telephone | 201-424-9338
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Fax |
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Provider Business Mailing Address
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Address Line | 15 SOMERSET LN APT 106
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City | EDGEWATER
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State | NJ
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Zip | 07020-2414
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Country | US
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Telephone | 201-424-9338
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Fax |
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Authorized Official
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Title or Position | DENTIST, OWNER
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Name | DR. KYUNG SUNG
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Credential |
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Telephone | 201-424-9338
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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 |
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License Number State |
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