Individual
DR. MATTHEW M KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
621A N FODALE AVE, SOUTHPORT, NC 28461-3550
(908) 307-1903
Mailing address
621A N FODALE AVE, SOUTHPORT, NC 28461-3550
(908) 307-1903
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14596
NC
122300000X
Dentist
Primary
40760
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/04/2023
Last updated
07/10/2026
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