Individual
DR. JAEGAK KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
850 HARRISON AVE FL 6, BOSTON, MA 02118-4001
(617) 414-2243
Mailing address
100 E NEWTON ST, BOSTON, MA 02118-2308
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DL13281
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2017
Last updated
06/30/2017
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