Organization
PEDIATRIC DENTISTRY OF MICHIGAN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WANKI KIM DDS (OWNER)
(917) 597-6749
Entity
Organization
Contact information
Practice address
3297 EAGLE RUN DR NE, GRAND RAPIDS, MI 49525-7050
(917) 597-6749
Mailing address
3297 EAGLE RUN DR NE, GRAND RAPIDS, MI 49525-7050
(917) 597-6749
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
08/30/2020
Last updated
01/25/2021
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