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NPI 1972714756

NPI 1972714756 : HOMING KIM DMD : FRANKFORT, KY

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General NPI Number Information
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    NPI Number           |    1972714756
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    Entity Type          |    Individual 
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    Provider Name        |    HOMING KIM DMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/24/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    938 LOUISVILLE RD 200
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    City                 |    FRANKFORT
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    State                |    KY
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    Zip                  |    40601
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    Country              |    US
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    Telephone            |    502-875-9862
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    Fax                  |    502-875-9793
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Provider Business Mailing Address
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    Address Line         |    938 LOUISVILLE ROAD SUITE 200
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    City                 |    FRANKFORT
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    State                |    KY
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    Zip                  |    40601
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    Country              |    US
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    Telephone            |    502-875-9862
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    Fax                  |    502-875-9793
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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        |    1223P0300X
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    Taxonomy Name        |    Periodontics
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    License Number       |    6465
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    License Number State |    KY
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