Individual
CHAN BAE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
30640 PACIFIC HWY S STE A, FEDERAL WAY, WA 98003-4889
(253) 946-3895
Mailing address
30640 PACIFIC HWY S STE A, FEDERAL WAY, WA 98003-4889
(253) 946-3895
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60483705
WA
1223G0001X
General Practice Dentistry
59574
CA
1223G0001X
General Practice Dentistry
6250
OK
Other
Enumeration date
11/05/2010
Last updated
01/18/2024
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