Individual
DR. JENNIFER KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
3020 ROSWELL RD STE 110, MARIETTA, GA 30062
(770) 855-4617
Mailing address
3142 BARKLEY SQUARE DR, DULUTH, GA 30097-3464
(770) 855-4617
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013329
GA
1223P0700X
Prosthodontics
DN013329
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003127719A
—
GA
Enumeration date
05/23/2007
Last updated
05/13/2018
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