Individual
DR. ALEN CRYSTAL KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3592 HIGHWAY 138 SE, STOCKBRIDGE, GA 30281-4171
(770) 506-3955
(770) 506-3225
Mailing address
3592 HIGHWAY 138 SE, STOCKBRIDGE, GA 30281-4171
(770) 789-4511
(770) 506-3255
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12298
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12298
DENTIST STATE LICENSE
GA
Enumeration date
01/24/2007
Last updated
07/08/2007
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