| NPI | 1316509367 |
|---|---|
| Former Name | GRACE MISUN KIM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA DN1858542) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1858542) |
| Enumeration Date | 2019-06-30 |
| Last Update Date | 2026-04-08 |