Provider Demographics
NPI:1306889449
Name:KIM, DANIEL J (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 INTERSTATE SHOP CTR
Mailing Address - Street 2:RAMSEY DENTAL
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2817
Mailing Address - Country:US
Mailing Address - Phone:201-327-4040
Mailing Address - Fax:201-327-1171
Practice Address - Street 1:135 INTERSTATE SHOP CTR
Practice Address - Street 2:RAMSEY DENTAL
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2817
Practice Address - Country:US
Practice Address - Phone:201-327-4040
Practice Address - Fax:201-327-1171
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022023001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice