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Individual
KIM QUY DO
Active
Individual
KIM QUY DO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401006973
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000039191
DENTAL BENEFIT PROVIDERS
—
01
—
0084916
ANTHEM
—
01
—
54-121-44
AETNA HEALTH PLAN
—
05
—
9178677
—
VA
Enumeration date
07/24/2006
Last updated
07/09/2007
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