Male or Other

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

Provider Address

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