Jae Seon Kim
Prosthodontist
1430 John Wesley Gilbert Drive Gc-1024
Augusta
, Georgia 30912-1001
Jae Seon Kim
Prosthodontist
1430 John Wesley Gilbert Drive Gc-1024
Augusta
, Georgia 30912-1001
(706) 723-0266
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About
Features
Specialties
- Prosthodontist
Languages spoken
- English
Location
First Address
- Jae Seon Kim
- 1430 John Wesley Gilbert Drive Gc-1024
- Augusta, GA
- Zip : 30912-1001
- Fax : (706) 723-0266
- Phone : (706) 721-9633
Second Address
- Jae Seon Kim
- 1430 John Wesley Gilbert Drive Gc-1024
- Augusta, GA
- Zip : 30912-1001
- Fax : (706) 723-0266
- Phone : (706) 721-9633
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0700X | Prosthodontist | DNF000366 | GA |
National Provider Identifier
| NPI | 1053672022 |
|---|---|
| Provider Name | Jae Seon Kim |
| First Address | Augusta, GA 30912-1001 |
| Second Address | Augusta, GA 30912-1001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/06/2012 |
| Last Update Date | 06/06/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.