Individual
JENNIE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
188 LONGWOOD AVE, BOSTON, MA 02115-5888
(617) 432-1434
(617) 432-4258
Mailing address
44 WASHINGTON ST APT 612, BROOKLINE, MA 02445-7105
(703) 606-9269
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1859911
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
MA
Other
Enumeration date
06/07/2023
Last updated
08/03/2023
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