# GHIM PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Black Mountain Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467699843
- **Authorized official:** DR. HEEYUP GHIM D.M.D. (PRESIDENT)
- **Authorized official phone:** (702) 564-4498

## Contact information

- **Practice address:** 270 E HORIZON DR, SUITE 106, HENDERSON, NV 89015-8036
- **Practice address phone:** (702) 564-4498
- **Mailing address:** 840 VALLEY BRUSH ST, HENDERSON, NV 89052-3813
- **Mailing address phone:** (702) 564-4498

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4848 | NV | Yes |

## Other

- **Enumeration date:** 01/07/2009
- **Last updated:** 01/07/2009