Individual
JOHN D KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
110 E 9TH ST, TYLER, TX 75701-4227
(903) 991-4991
Mailing address
523 S FANNIN AVE, TYLER, TX 75702-8204
(903) 535-9041
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
319.020174
IL
122300000X
Dentist
Primary
38650
TX
Other
Enumeration date
07/28/2016
Last updated
04/08/2023
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