Individual
ANSONY KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
75 ARCAND DR, LOWELL, MA 01852-1026
(978) 323-4399
Mailing address
2591 MAIN ST, OAKLEY, CA 94561-1854
(925) 690-5437
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
103320
CA
1223P0221X
Pediatric Dentistry
DN1856837
MA
Other
Enumeration date
07/10/2013
Last updated
04/16/2020
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