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Organization
DOUGLAS W LIM A PROFESSIONAL DENTAL CORP
Active
Organization
DOUGLAS W LIM A PROFESSIONAL DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS W LIM DMD (OWNER)
(949) 650-8186
Entity
Organization
Contact information
Practice address
728 WEST 19TH ST, SUITE B, COSTA MESA, CA 92627-6148
(949) 650-8186
Mailing address
728 WEST 19TH ST, SUITE B, COSTA MESA, CA 92627-6148
(949) 650-8186
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
29938
CA
Other
Enumeration date
01/05/2007
Last updated
08/22/2020
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