Individual
KWANG HYO KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3670 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4413
(253) 212-3430
Mailing address
3670 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4413
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60672661
WA
Other
Enumeration date
09/09/2016
Last updated
09/09/2016
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