Individual
JAE SEON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1430 JOHN WESLEY GILBERT DRIVE, GC-1024, AUGUSTA, GA 30912-1001
(706) 721-9633
(706) 723-0266
Mailing address
1430 JOHN WESLEY GILBERT DRIVE, GC-1024, AUGUSTA, GA 30912-1001
(706) 721-9633
(706) 723-0266
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DNF000366
GA
Other
Enumeration date
06/06/2012
Last updated
06/06/2012
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