Individual
DR. DOUGLAS WILLIAM KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
570 PIERMONT RD STE C1, CLOSTER, NJ 07624-3100
(201) 666-2828
Mailing address
PO BOX 663, ALPINE, NJ 07620-0663
(201) 245-4362
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI02768300
NJ
Other
Enumeration date
04/15/2016
Last updated
11/19/2021
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