| NPI | 1083030092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIN Y. KIM Orthodontist 415-608-2837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 58103) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: CA 56935) |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2014-03-14 |