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General NPI Number Information
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NPI Number | 1154209237
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Entity Type | Organization
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Legal Business Name | KIM AND KIM FAMILY DENTAL GROUP PC
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 100 AMESBURY ST STE 204
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City | LAWRENCE
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State | MA
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Zip | 01840-1321
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Country | US
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Telephone | 978-683-5311
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Fax |
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Provider Business Mailing Address
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Address Line | 100 AMESBURY ST STE 204
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City | LAWRENCE
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State | MA
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Zip | 01840-1321
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Country | US
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Telephone | 978-683-5311
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DONG WON KIM
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Credential | DMD
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Telephone | 617-888-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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