Organization
SPROUT PEDIATRIC DENTISTRY LLC
Active
Other names
Sprout Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JEE-EUN KIM DMD (OWNER)
(678) 408-2121
Entity
Organization
Contact information
Practice address
3495 PEACHTREE PKWY STE 115, SUWANEE, GA 30024-9101
(678) 408-2121
(678) 408-2121
Mailing address
3495 PEACHTREE PKWY STE 115, SUWANEE, GA 30024-9101
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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