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Individual
NICHOLAS S KIM
Active
Individual
NICHOLAS S KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN1859729
MA
208600000X
Surgery Physician
1016683
MA
Other
Enumeration date
10/28/2019
Last updated
03/20/2024
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