Individual
SIWOO KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10201 WASHINGTONIAN BLVD APT 514, GAITHERSBURG, MD 20878-8310
(443) 996-0507
Mailing address
5 CABOT RD UNIT 338, MEDFORD, MA 02155-5295
(443) 996-0507
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18849
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/01/2024
Last updated
08/07/2025
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