Individual
DR. SANG YOON KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
361 MAPLE AVE W, SUITE 200, VIENNA, VA 22180-4304
(703) 255-9400
(703) 255-4958
Mailing address
361 MAPLE AVE W, SUITE 200, VIENNA, VA 22180-4304
(703) 255-9400
(703) 255-4958
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0401413454
VA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
0101251217
VA
Other
Enumeration date
04/03/2007
Last updated
06/14/2013
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