Provider Demographics
NPI:1538334867
Name:KIM, BYONGYOOL ALAN (DMD)
Entity type:Individual
Prefix:DR
First Name:BYONGYOOL
Middle Name:ALAN
Last Name:KIM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4122
Mailing Address - Country:US
Mailing Address - Phone:201-969-1087
Mailing Address - Fax:201-969-9118
Practice Address - Street 1:891 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4122
Practice Address - Country:US
Practice Address - Phone:201-969-1087
Practice Address - Fax:201-969-9118
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 188711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice