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General NPI Number Information
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NPI Number | 1457801334
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Entity Type | Organization
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Legal Business Name | SUSAN J KIM DMD LLC
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 538 E LINCOLN HWY FLOOR 1
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City | COATESVILLE
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State | PA
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Zip | 19320-3414
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Country | US
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Telephone | 610-384-5349
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Fax |
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Provider Business Mailing Address
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Address Line | 538 E LINCOLN HWY FLOOR 1
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City | COATESVILLE
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State | PA
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Zip | 19320-3414
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | SUSAN KIM-MORRIS
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Credential |
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Telephone | 610-384-5349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS028913L
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License Number State | PA
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