# BSJC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659885523
- **Authorized official:** DR. JONGSUNG KIM DDS (CEO)
- **Authorized official phone:** (671) 300-3221

## Contact information

- **Practice address:** 692 N MARINE CORPS DR STE 301, TAMUNING, GU 96913-4454
- **Practice address phone:** (671) 300-3221
- **Practice address fax:** (671) 300-3223
- **Mailing address:** 692 N MARINE CORPS DR STE 301, TAMUNING, GU 96913-4454
- **Mailing address phone:** (671) 300-3221
- **Mailing address fax:** (671) 300-3223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | D1014 | GU | Yes |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 1223P0300X | Periodontics | — | — | — |

## Other

- **Enumeration date:** 11/29/2017
- **Last updated:** 11/29/2017