Individual
DR. JAE KYONG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3080 N EASTMAN RD STE 104, LONGVIEW, TX 75605-7978
(903) 686-0086
Mailing address
9672 MINTON DR, FORT WORTH, TX 76108-3887
(817) 914-7037
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
39882
TX
Other
Enumeration date
07/31/2023
Last updated
08/01/2023
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