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Individual

DR. SOO JIN NAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
4195 PLEASANT HILL RD STE 200, DULUTH, GA 30096-6385
(770) 814-7533
Mailing address
770 VISTA BLUFF DR, DULUTH, GA 30097
(770) 845-4406

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN012863
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
896730672A
GA
Enumeration date
01/09/2006
Last updated
11/01/2022
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