| NPI | 1316675333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICKOLAS KIM Dentist 323-420-4044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2022-09-01 |