Organization
YONGJAE KIM, DDS, PLLC
Active
Other names
Lynnwood Prime Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
YONGJAE KIM DDS (MEMBER)
(425) 457-3638
Entity
Organization
Contact information
Practice address
3333 184TH ST SW, SUITE #U, LYNNWOOD, WA 98037-4724
(425) 251-0707
Mailing address
PO BOX 4086, BELLEVUE, WA 98009-4086
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE00011115
WA
122300000X
Dentist
Primary
DE00011116
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5060132
—
WA
Enumeration date
06/20/2009
Last updated
12/10/2009
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