Individual
EDWARD KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(646) 464-2508
Mailing address
75 SAINT ALPHONSUS ST, 910, BOSTON, MA 02120-1676
(646) 464-2508
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DL12041
MA
Other
Enumeration date
09/05/2013
Last updated
09/05/2013
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