Kim, Jennifer

Kim, Jennifer is an individual health care provider with primary practice located at 3020 Roswell Rd Ste 110 , Marietta GA 30062. She recently has 2 registered licenses in different health care specialties including Dental Providers / Prosthodontics, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Kim, Jennifer can be contacted via phone (770) 855-4617.

Contact Information

Primary practice address
3020 Roswell Rd Ste 110 Marietta GA 30062
Phone: (770) 855-4617
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Prosthodontics 1223P0700X DN013329 Georgia
Dental Providers / General Practice 1223G0001X DN013329 Georgia

Profile Details

NPI number 1366652737
LBN Legal business name Kim, Jennifer
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated May 13th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366652737 NPPES
Georgia MEDICAID 003127719A

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