Provider Demographics
NPI:1780140855
Name:LIM, JOONBUM (DDS MSC)
Entity type:Individual
Prefix:DR
First Name:JOONBUM
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:DDS MSC
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Other - Credentials:
Mailing Address - Street 1:1105 WESTCHESTER HALL
Mailing Address - Street 2:DEPARTMENT OF PROSTHODONTICS AND DIGITAL TECHNOLOGY
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8712
Mailing Address - Country:US
Mailing Address - Phone:631-632-3161
Mailing Address - Fax:631-632-3961
Practice Address - Street 1:1105 WESTCHESTER HALL
Practice Address - Street 2:DEPARTMENT OF PROSTHODONTICS AND DIGITAL TECHNOLOGY
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8712
Practice Address - Country:US
Practice Address - Phone:631-632-3161
Practice Address - Fax:631-632-3961
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program