# JAMES YOUNG KIM DENTAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003388307
- **Authorized official:** JAMES YOUNG KIM (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (760) 779-5662

## Contact information

- **Practice address:** 74420 HIGHWAY 111 STE 1, PALM DESERT, CA 92260-4144
- **Practice address phone:** (760) 779-5662
- **Practice address fax:** (760) 779-5683
- **Mailing address:** 74420 HIGHWAY 111 STE 1, PALM DESERT, CA 92260-4144
- **Mailing address phone:** (760) 779-5662

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/26/2018
- **Last updated:** 08/11/2022