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General NPI Number Information
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NPI Number | 1962269787
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Entity Type | Organization
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Legal Business Name | KIM & NAM LLC
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 1797 N ELM ST
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City | COMMERCE
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State | GA
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Zip | 30529-2351
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Country | US
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Telephone | 706-335-5501
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Fax |
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Provider Business Mailing Address
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Address Line | 6931 CEDAR GLEN RD
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City | ATLANTA
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State | GA
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Zip | 30360-2912
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Country | US
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Telephone | 732-801-3084
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Fax |
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Authorized Official
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Title or Position | SINGLE MEMBER
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Name | DR. VICTOR KIM
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Credential | DMD
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Telephone | 732-801-3084
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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 |
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License Number State |
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