Provider Demographics
NPI:1871643064
Name:KIM, PAUL H (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:H
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 MARKET ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08102-1572
Mailing Address - Country:US
Mailing Address - Phone:856-963-0315
Mailing Address - Fax:856-963-0315
Practice Address - Street 1:433 MARKET ST STE 102
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08102-1572
Practice Address - Country:US
Practice Address - Phone:856-963-0315
Practice Address - Fax:856-963-0315
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57203122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist