Provider Demographics
NPI:1104901388
Name:KIM, MARI TOYONG (DDS)
Entity type:Individual
Prefix:DR
First Name:MARI
Middle Name:TOYONG
Last Name:KIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12600 ALBROOK DR.
Mailing Address - Street 2:DENTAL DEPARTMENT
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12600 ALBROOK DRIVE
Practice Address - Street 2:DENTAL DEPARTMENT
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239
Practice Address - Country:US
Practice Address - Phone:303-602-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5109122300000X
CA54734122300000X
NY053350122300000X
CODEN.00202484122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist