Provider Demographics
NPI:1003352857
Name:KIMCHANG & COMPANY, LLC
Entity Type:Organization
Organization Name:KIMCHANG & COMPANY, LLC
Other - Org Name:POST OAK PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEUNGBUM
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-900-8830
Mailing Address - Street 1:2155 POST OAK TRITT RD STE 450
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8608
Mailing Address - Country:US
Mailing Address - Phone:770-971-5536
Mailing Address - Fax:770-971-3046
Practice Address - Street 1:2155 POST OAK TRITT RD STE 450
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8608
Practice Address - Country:US
Practice Address - Phone:770-971-5536
Practice Address - Fax:770-971-3046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0136291223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty