Provider Demographics
NPI:1568139038
Name:KIM M POWER DDS PLLC
Entity Type:Organization
Organization Name:KIM M POWER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:POWER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-418-0538
Mailing Address - Street 1:4028 WINECOTT DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-9316
Mailing Address - Country:US
Mailing Address - Phone:919-418-0538
Mailing Address - Fax:
Practice Address - Street 1:910 S BRIGHTLEAF BLVD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4388
Practice Address - Country:US
Practice Address - Phone:919-300-5890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty