Individual
MIN TAE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1045 OLD PEACHTREE RD NW APT 2210, SUWANEE, GA 30024-5066
(224) 234-2460
Mailing address
1045 OLD PEACHTREE RD NW APT 2210, SUWANEE, GA 30024-5066
(224) 234-2460
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019031328
IL
Other
Enumeration date
09/07/2017
Last updated
06/18/2024
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