Nam, Soo Jin
Nam, Soo Jin is an sole proprietor health care provider with primary practice located at 4195 Pleasant Hill Rd Ste 200 , Duluth GA 30096-6385. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Nam, Soo Jin can be contacted via phone (770) 814-7533.Contact Information
Primary practice address
4195 Pleasant Hill Rd Ste 200
Duluth GA 30096-6385
Phone: (770) 814-7533
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN012863 | Georgia |
Profile Details
| NPI number | 1134107253 |
|---|---|
| LBN Legal business name | Nam, Soo Jin |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 9th, 2006 |
| Last updated | Nov 1st, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134107253 | NPPES |
| Georgia | MEDICAID | 896730672A |
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