NPI | 1518622190 |
---|---|
Entity Type | Organization |
Authorized Contact | JOO HYUNG N/A KIM Dentist/Owner 909-875-8670 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
1223P0700X Dentist, Prosthodontics | |
Enumeration Date | 2021-11-08 |
Last Update Date | 2021-11-08 |