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General NPI Number Information
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NPI Number | 1326494840
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Entity Type | Individual
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Provider Name | YUN AE KIM D.M.D
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Gender | Female
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 1 COLLEGE ST
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City | PORTLAND
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State | ME
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Zip | 04103-2617
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Country | US
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Telephone | 207-221-4717
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Fax |
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Provider Business Mailing Address
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Address Line | 9 COLE ST APT 12
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-4210
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Country | US
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Telephone | 508-330-6242
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DEN5109
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License Number State | ME
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