John Kim

NPI #1316111248 in Loves Park, Illinois

Provider Information

NPI Number: 1316111248
Entity Type: Individual
Name: John Kim
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Apr 22, 2008
Last Updated: Apr 22, 2008

Practice Location

Address: 438 THEODORE ST
City: Loves Park
State: Illinois
ZIP Code: 61111-4056
Phone: (815) 633-7933

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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