Provider Demographics
NPI:1972021277
Name:WATSON, YUNMI KIM (DMD)
Entity Type:Individual
Prefix:DR
First Name:YUNMI
Middle Name:KIM
Last Name:WATSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 WISSAHICKON AVE APT 310
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4536
Mailing Address - Country:US
Mailing Address - Phone:202-390-6457
Mailing Address - Fax:
Practice Address - Street 1:6412 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-3005
Practice Address - Country:US
Practice Address - Phone:215-792-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS041479122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist