| NPI | 1780738112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYONG H KIM Owner 803-528-3383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4145) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 047812) |
| 1223G0001X Dentist, General Practice (Licence: CA 39288) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |