# KOBAWOO DENTAL CENTER

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

## Provider details

- **NPI number:** 1326400748
- **Authorized official:** DR. HE-KYUNG KIM-YU D.M.D. (DENTIST)
- **Authorized official phone:** (215) 362-3000

## Contact information

- **Practice address:** 1222 WELSH RD, SUITE G, NORTH WALES, PA 19454-2054
- **Practice address phone:** (215) 362-3000
- **Practice address fax:** (267) 263-1499
- **Mailing address:** 1222 WELSH RD, SUITE G, NORTH WALES, PA 19454-2054
- **Mailing address phone:** (215) 362-3000
- **Mailing address fax:** (267) 263-1499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS026455L | PA | Yes |

## Other

- **Enumeration date:** 03/24/2016
- **Last updated:** 03/24/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1026469620001 | — | PA |