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Individual
JOHN KIM
Active
Individual
JOHN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE60678182
WA
1223G0001X
General Practice Dentistry
Primary
65365
CA
Other
Enumeration date
01/18/2016
Last updated
07/06/2022
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