| NPI | 1710018254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANGSOOK KIM Dentist 626-357-9909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 39166) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 39166CA) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2008-07-11 |