Individual
CHARLES JUNGHYUN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10217 19TH AVE SE STE 202, EVERETT, WA 98208-4266
(425) 220-7512
Mailing address
10217 19TH AVE SE STE 202, EVERETT, WA 98208-4266
(425) 220-7512
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE8256
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5041512
—
WA
Enumeration date
08/01/2006
Last updated
07/09/2007
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