# DAE HO KIM DDS PC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chicago Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386053973
- **Authorized official:** DR. DAE HO KIM DDS (PRESIDENT/DENTIST)
- **Authorized official phone:** (425) 353-4469

## Contact information

- **Practice address:** 5929 EVERGREEN WAY, SUITE 100, EVERETT, WA 98203-6031
- **Practice address phone:** (425) 353-4469
- **Mailing address:** 5929 EVERGREEN WAY, SUITE 100, EVERETT, WA 98203-6031
- **Mailing address phone:** (425) 353-4469

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 60307878 | WA | Yes |

## Other

- **Enumeration date:** 08/07/2014
- **Last updated:** 08/07/2014