Individual
STEPHANIE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4250 ROSWELL RD STE 110, MARIETTA, GA 30062-8114
(770) 509-5585
Mailing address
3097 MAPLE DR NE APT 544, ATLANTA, GA 30305-3056
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015647
GA
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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