| NPI | 1659824373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANA KIM President 310-562-9585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 00202980) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: CA 59646) |
| 261QD0000X Clinic/Center Dental (Licence: CO 00202980) | |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2016-10-25 |