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Individual
JEFFREY MARK KIM
Active
Individual
JEFFREY MARK KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN13917
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN13917
STATE LICENSE NUMBER
FL
Enumeration date
01/05/2012
Last updated
01/05/2012
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