Provider Demographics
NPI:1104149889
Name:KIM-HULL, EMILY EUNSOO (DMD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:EUNSOO
Last Name:KIM-HULL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 E CAMPBELL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2129
Mailing Address - Country:US
Mailing Address - Phone:408-761-5662
Mailing Address - Fax:408-374-9407
Practice Address - Street 1:486 E CAMPBELL AVE STE 101
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2129
Practice Address - Country:US
Practice Address - Phone:408-761-5662
Practice Address - Fax:408-374-9407
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38858122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist