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General NPI Number Information
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NPI Number | 1477003903
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Entity Type | Organization
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Legal Business Name | SARAH KIM, DMD, PC
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Dates
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Enumeration Date | 10/07/2016
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Last Update Date | 10/07/2016
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Provider Practice Location Address
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Address Line | 350 HANCOCK ST
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City | QUINCY
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State | MA
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Zip | 02171-2439
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Country | US
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Telephone | 617-471-5255
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Fax |
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Provider Business Mailing Address
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Address Line | 350 HANCOCK ST
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City | QUINCY
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State | MA
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Zip | 02171-2439
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Country | US
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Telephone | 617-471-5255
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Fax |
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | SARAH KIM
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Credential | DMD
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Telephone | 617-388-7181
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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 | DN22315
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License Number State | MA
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