| 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 |