Individual
JI HYUN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
470 LEWIS AVE, MERIDEN, CT 06451-2103
(203) 440-0499
Mailing address
470 LEWIS AVE, MERIDEN, CT 06451-2103
(203) 440-0499
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
010500
CT
Other
Enumeration date
06/27/2011
Last updated
08/01/2011
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