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Organization
PRIVATE DENTAL GROUP
Active
Organization
PRIVATE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT C. KIM DDS (PRESIDENT)
(858) 457-3610
Entity
Organization
Contact information
Practice address
8950 VILLA LA JOLLA DR STE B124, LA JOLLA, CA 92037-1704
(858) 457-3610
(858) 457-4025
Mailing address
8950 VILLA LA JOLLA DR STE B124, LA JOLLA, CA 92037-1704
(858) 457-3610
(858) 457-4025
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/11/2018
Last updated
01/23/2025
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