NPI 1003193152

Bongok Kim

Practitioner Prosthodontics Lincoln, NE

Practice location

Address: 3885 Holdrege St., Lincoln, NE 68583-0740
Phone: (402) 472-8900
Mailing address: Pobox 830740, Lincoln, NE 68583-0740

Registered specialties

Prosthodontics Primary

Dental Providers Taxonomy 1223P0700X Licence 6993 (NE)

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Registry record

NPI: 1003193152
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 Nov 2011
Record last updated: 3 Nov 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.