Organization
LISA PARK DDS & SIMONE KIM DDS
Active
Other names
Fremont Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SIMONE KIM DDS (CO-OWNER)
(206) 675-0366
Entity
Organization
Contact information
Practice address
3601 FREMONT AVE N, SUITE 316, SEATTLE, WA 98103-2709
(206) 675-0366
(206) 675-0466
Mailing address
3601 FREMONT AVE N, SUITE 316, SEATTLE, WA 98103-2709
(206) 675-0366
(206) 675-0466
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
743094945
WA
1223G0001X
General Practice Dentistry
743094948
WA
Other
Enumeration date
12/01/2008
Last updated
12/01/2008
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