Individual
CASEY SEOL KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
305 W 12TH AVE, COLUMBUS, OH 43210-1267
(614) 688-3763
Mailing address
305 W 12TH AVE, COLUMBUS, OH 43210-1267
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.027812
OH
390200000X
Student in an Organized Health Care Education/Training Program
RES.004612
OH
Other
Enumeration date
04/18/2023
Last updated
06/11/2025
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