Individual
DR. MICHAEL HANSOO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
21001 SYCOLIN RD, SUITE 240, ASHBURN, VA 20147-4073
(703) 723-4224
Mailing address
21001 SYCOLIN RD, SUITE 240, ASHBURN, VA 20147-4073
(703) 723-4224
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401413573
VA
122300000X
Dentist
2901018597
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4631948
—
MI
05
—
4631957
—
MI
Enumeration date
07/28/2006
Last updated
08/28/2014
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