Individual
DR. KEVIN MINSUNG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1717 OLYMPIA WAY, LONGVIEW, WA 98632-3929
(360) 636-1900
Mailing address
1717 OLYMPIA WAY, LONGVIEW, WA 98632-3929
(360) 636-1900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE61034697
WA
1223G0001X
General Practice Dentistry
DE61034697
WA
1223P0221X
Pediatric Dentistry
Primary
DE61034697
WA
Other
Enumeration date
05/26/2018
Last updated
07/22/2020
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