Provider Demographics
NPI:1922447606
Name:KIM, HOON (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOON
Middle Name:
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 1:39555 W 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375
Mailing Address - Country:US
Mailing Address - Phone:248-442-7305
Mailing Address - Fax:
Practice Address - Street 1:7743 GRAND RIVER RD STE 202
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-3399
Practice Address - Country:US
Practice Address - Phone:810-229-0303
Practice Address - Fax:810-229-7361
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010210141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice