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General NPI Number Information
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NPI Number | 1639655764
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Entity Type | Organization
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Legal Business Name | KISS DENTAL CARE PLLC
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Dates
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Enumeration Date | 07/11/2018
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 425 ROBINSON AVE STE 4
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City | NEWBURGH
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State | NY
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Zip | 12550-3303
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Country | US
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Telephone | 845-561-2213
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Fax |
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Provider Business Mailing Address
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Address Line | 425 ROBINSON AVE STE 4
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City | NEWBURGH
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State | NY
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Zip | 12550-3303
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Country | US
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Telephone | 845-561-2213
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Fax |
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Authorized Official
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Title or Position | MANAGER/MEMBER
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Name | DR. UNG-GIN YOON
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Credential | DDS
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Telephone | 845-561-2213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 048787
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License Number State | NY
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