Individual
NICK KIM
Active
Individual
NICK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
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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