Individual
NICK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6649 ENCORE BLVD, SANDY SPRINGS, GA 30328-2889
(334) 549-2714
Mailing address
6649 ENCORE BLVD, SANDY SPRINGS, GA 30328-2889
(334) 549-2714
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS041448
PA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN016023
GA
Other
Enumeration date
08/31/2017
Last updated
04/27/2020
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