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Individual
STEPHEN KIM
Active
Individual
STEPHEN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
104758
CA
1223G0001X
General Practice Dentistry
D10620
OR
1223G0001X
General Practice Dentistry
D9973
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/10/2016
Last updated
06/08/2023
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