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NPI Code Detail

MEDICARE: NARI KIM DMD

MEDICARE: NARI KIM DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDS037880PA

General Provider Information

NPI Number : 1386945574
Entity Type Code : Individual
Provider Name (Legal Business Name) : NARI KIM DMD
Provider Business Mailing Address
First Line : 1701 E MOYAMENSING AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19148-1931
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 E MOYAMENSING AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19148-1931
Country : US
Telephone Number : 215-462-4047
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2010
Last Update Date : 07/01/2011

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