Individual
MIN JUNG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
124 ROSEWICK RD, LA PLATA, MD 20646-4251
(301) 934-4357
Mailing address
124 ROSEWICK RD, LA PLATA, MD 20646-4251
(301) 934-4357
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401414043
VA
1223G0001X
General Practice Dentistry
Primary
16099
MD
1223G0001X
General Practice Dentistry
50056823
NY
Other
Enumeration date
05/08/2012
Last updated
11/18/2015
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