Individual
BOWON KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
126 INMAN ST, CAMBRIDGE, MA 02139-1206
(617) 492-8210
Mailing address
2 LEIGHTON ST APT 340, CAMBRIDGE, MA 02141-3007
(347) 244-9498
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1858585
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2018
Last updated
02/25/2021
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