Individual
DR. JANICE JIHEE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
27072 SW BALLSTON RD, SHERIDAN, OR 97378-9620
(503) 843-6461
Mailing address
27072 SW BALLSTON RD, SHERIDAN, OR 97378-9620
(503) 843-6461
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901017715
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901017715
DENTAL LICENSE
MI
Enumeration date
03/25/2019
Last updated
06/11/2019
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