Provider Demographics
NPI:1003196924
Name:LIM, MEE KYUNG (DMD)
Entity Type:Individual
Prefix:
First Name:MEE
Middle Name:KYUNG
Last Name:LIM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MEE
Other - Middle Name:
Other - Last Name:LIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:401 COMMERCE DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2714
Mailing Address - Country:US
Mailing Address - Phone:267-460-4254
Mailing Address - Fax:215-646-6166
Practice Address - Street 1:456 SCHOOL LN
Practice Address - Street 2:SUITE 104
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-1703
Practice Address - Country:US
Practice Address - Phone:215-513-7172
Practice Address - Fax:215-513-7192
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038830122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist