Individual
SCOTT KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
45 COLONY RD, EDGEWATER, NJ 07020-1505
(301) 821-1106
Mailing address
8 LOCKSLEY AVE APT 8M, SAN FRANCISCO, CA 94122-3850
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
13678
CT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI02829500
NJ
Other
Enumeration date
03/04/2019
Last updated
08/07/2023
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