Individual
DR. BACKHABWHA KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
222 E CHALAN SANTO PAPA STE 304, HAGATNA, GU 96910-5175
(671) 472-6824
Mailing address
222 E CHALAN SANTO PAPA STE 304, HAGATNA, GU 96910-5175
(671) 472-6824
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DL12315
MA
1223P0221X
Pediatric Dentistry
Primary
D1028
GU
Other
Enumeration date
09/30/2014
Last updated
12/16/2019
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