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Organization
KDENTISTRY26 LLC
Active
Organization
KDENTISTRY26 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YOUNG DO KIM DDS (MEMBER)
(404) 641-5993
Entity
Organization
Contact information
Practice address
403 N GILMER AVE STE B, LANETT, AL 36863-2053
(334) 623-0180
(334) 623-0190
Mailing address
403 N GILMER AVE STE B, LANETT, AL 36863-2053
(334) 623-0180
(334) 623-0190
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841892247
INDIVIDUAL NPI
—
Enumeration date
08/13/2021
Last updated
08/13/2021
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