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General NPI Number Information
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NPI Number | 1376642801
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Entity Type | Organization
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Legal Business Name | JOSEPH J KIM DDS PS
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 300 E 24TH ST
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City | VANCOUVER
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State | WA
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Zip | 98663-3214
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Country | US
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Telephone | 360-694-4000
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Fax | 360-694-1647
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Provider Business Mailing Address
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Address Line | 300 E 24TH ST
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City | VANCOUVER
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State | WA
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Zip | 98663-3214
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Country | US
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Telephone | 360-694-4000
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Fax | 360-694-1647
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH JUNE KIM
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Credential | DDS
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Telephone | 360-694-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE 9988
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License Number State | WA
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