Individual
DR. JUNG KI KIM X
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.,P.S.
Contact information
Practice address
1519 E EDISON AVE, SUNNYSIDE, WA 98944-1624
(509) 837-3292
(509) 837-3448
Mailing address
PO BOX 58, SUNNYSIDE, WA 98944-0058
(509) 837-3292
(509) 837-3448
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00006739
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49548
L&I
WA
05
—
5013594
—
WA
01
—
867897
UNITED CONCORDIA
WA
Enumeration date
07/19/2006
Last updated
07/09/2007
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