Individual
WAN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 PEACHTREE INDUSTRIAL BLVD, #203, SUWANEE, GA 30024-2013
(770) 904-7005
Mailing address
1120 PEACHTREE INDUSTRIAL BLVD, #203, SUWANEE, GA 30024-2013
(770) 904-7005
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
04/20/2011
Last updated
04/20/2011
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