Individual
YEONJOO KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
4533 WOODRUFF RD, COLUMBUS, GA 31904-6013
(706) 660-8001
Mailing address
1909 GRANVILLE DR, LAWRENCEVILLE, GA 30043-7975
(954) 682-0666
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013991
GA
1223P0221X
Pediatric Dentistry
DN013991
GA
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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