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Organization
KIM & KIM PROFESSIONAL DENTAL CORP
Active
Organization
KIM & KIM PROFESSIONAL DENTAL CORP
Active
Other names
Pico Vista Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOOWON KIM D.D.S. (PRESIDENT)
(917) 842-3225
Entity
Organization
Contact information
Practice address
2300 W PICO BLVD, SUITE 204, LOS ANGELES, CA 90006-4021
(213) 385-6919
Mailing address
4887 LA PALMA AVE, LA PALMA, CA 90623-2019
(714) 778-6614
(562) 402-6377
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
54775
CA
1223G0001X
General Practice Dentistry
54886
CA
Other
Enumeration date
08/30/2013
Last updated
08/30/2013
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