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General NPI Number Information
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NPI Number | 1679383269
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Entity Type | Organization
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Legal Business Name | NDK DENTAL, LLC
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 5835 POST ROAD, UNIT 113
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City | EAST GREENWICH
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State | RI
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Zip | 02818
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Country | US
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Telephone | 401-477-9713
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Fax |
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Provider Business Mailing Address
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Address Line | 5835 POST ROAD, UNIT 113
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City | EAST GREENWICH
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State | RI
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Zip | 02818
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Country | US
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Telephone | 401-477-9713
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Fax |
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Authorized Official
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Title or Position | LLC MANAGER
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Name | GARY KIM
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Credential |
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Telephone | 401-477-9713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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