Dr. Stanley Kim D.D.S.
Periodontist in Worcester, MA(View on Map)
Full Name
Dr. Stanley Kim D.D.S.
NPI Number
1962805101
NPI Type
Individual Provider
Gender
Male
Enumeration Date
10/02/2014
Specialties
(Taxonomies)Code
1223P0300X
122300000X
1223G0001X
Primary Taxonomy
Yes
No
No
Licenses
State
Connecticut
Maryland
Massachusetts
Massachusetts
License Number
11301
15864
DN1859667
14897
Contact
Information
Purpose
Mailing
Location
Address
125 FRANKLIN ST APT 2528
65 ELM ST
City
Worcester
Worcester
State
MA
MA
Postal Code
01608-1478
01609-2547
Country
US
US
Telephone Number
(347) 642-0002
(508) 466-6942
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/23/2024