Organization
SEONG W. KIM, DMD, LLC
Active
Other names
PEACHTREE DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
SEONG KIM (OWNER)
(503) 473-4839
Entity
Organization
Contact information
Practice address
13056 SE DIVISION ST, PORTLAND, OR 97236-3039
(503) 760-1341
Mailing address
13056 SE DIVISION ST, PORTLAND, OR 97236-3039
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9495
OR
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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