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General NPI Number Information
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NPI Number | 1841654761
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Entity Type | Individual
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Provider Name | KIE H. KIM DMD
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Gender | Male
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 12/11/2019
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Provider Practice Location Address
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Address Line | 651 HIGH ST
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City | BURLINGTON
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State | NJ
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Zip | 08016-2737
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Country | US
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Telephone | 609-386-0775
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Fax |
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Provider Business Mailing Address
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Address Line | 1 N WHITE HORSE PIKE
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City | HAMMONTON
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State | NJ
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Zip | 08037-1875
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Country | US
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Telephone | 609-567-0434
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02652700
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License Number State | NJ
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