Individual
JI S KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., PLLC
Contact information
Practice address
26750 GRAND RIVER AVE, REDFORD, MI 48240-1529
(313) 531-2000
(313) 531-1063
Mailing address
26750 GRAND RIVER AVE, REDFORD, MI 48240-1529
(313) 531-2000
(313) 531-1063
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901019035
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124845452
—
MI
Enumeration date
11/29/2006
Last updated
07/08/2007
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