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General NPI Number Information
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NPI Number | 1821246729
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Entity Type | Individual
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Provider Name | JOSEPH KIM D.D.S., D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 2005 BOGGS RD STE 104
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City | DULUTH
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State | GA
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Zip | 30096-4602
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Country | US
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Telephone | 770-497-0882
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Fax | 770-497-0861
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Provider Business Mailing Address
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Address Line | 2005 BOGGS RD STE 104
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City | DULUTH
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State | GA
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Zip | 30096-4602
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Country | US
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Telephone | 770-497-0885
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Fax | 770-497-0861
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR005434
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN013766
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License Number State | GA
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