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Organization
KELLY KIM DENTAL CORPORATION
Active
Organization
KELLY KIM DENTAL CORPORATION
Active
Other names
MY KIDS DENTIST AND ORTHODONTICS
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY KIM DDS (OWNER)
(951) 543-9745
Entity
Organization
Contact information
Practice address
25100 HANCOCK AVE STE 102, MURRIETA, CA 92562-5973
(951) 543-9745
(951) 543-4178
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(951) 543-9745
(951) 543-4178
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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