Individual
KATIE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3501 SCHOOL ST, LAFAYETTE, CA 94549-4505
(925) 385-8051
Mailing address
2999 BOWERY LN, SAN JOSE, CA 95135-1543
(408) 499-8287
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
106104
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/13/2019
Last updated
01/28/2023
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