Individual
DR. KRIS KIM
Active
Individual
DR. KRIS KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.D.
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE60058462
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE60058462
WASHINGTON STATE DENTAL LICENSE
WA
Enumeration date
03/01/2010
Last updated
03/01/2010
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