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Organization
RA AND KIM DENTAL CORP
Active
Organization
RA AND KIM DENTAL CORP
Active
Other names
Lakeside Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHIL JAE RA D.D.S. (DENTIST)
(909) 866-0606
Entity
Organization
Contact information
Practice address
42002 FOX FARM ROAD #101, BIG BEAR LAKE, CA 92315-6951
(909) 866-0606
(909) 866-5546
Mailing address
PO BOX 6951, 42002 FOX FARM ROAD #101, BIG BEAR LAKE, CA 92315-6951
(909) 866-0606
(909) 866-5546
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/20/2007
Last updated
08/22/2020
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