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Individual
DR. SANDRA KIM
Active
Individual
DR. SANDRA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401412651
VA
122300000X
Dentist
15220
MD
122300000X
Dentist
Primary
DEN1000804
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200285280
—
IN
Enumeration date
01/13/2006
Last updated
04/08/2021
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