Individual
DR. MOOCHAN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
610 DR CALVIN JONES HWY STE 100, WAKE FOREST, NC 27587-3104
(919) 336-5230
Mailing address
4701 VIOLET FIELDS WAY UNIT 218, RALEIGH, NC 27612-5660
(917) 421-0997
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.032304
IL
122300000X
Dentist
062241
NY
122300000X
Dentist
22DI02925300
NJ
1223E0200X
Endodontics
Primary
13969
NC
Other
Enumeration date
07/29/2019
Last updated
09/03/2024
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