Individual
SAMANTHA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 JACKSON ST, METHUEN, MA 01844
(978) 874-3320
Mailing address
40 JACKSON ST, METHUEN, MA 01844-5000
(978) 874-3320
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN10000398
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2023
Last updated
09/11/2024
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