Individual
GRACE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2595 CENTRAL AVE, MEMPHIS, TN 38104-5905
(901) 842-3160
Mailing address
2595 CENTRAL AVE, MEMPHIS, TN 38104-5905
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11647
TN
Other
Enumeration date
07/12/2021
Last updated
11/14/2021
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