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Organization
SAE ROM KIM.DDS.INC
Active
Organization
SAE ROM KIM.DDS.INC
Active
Parent organization
SAE ROM KIM.DDS.INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAE ROM KIM.DDS.INC
Authorized official
SAE ROM KIM (PRESIDENT)
(760) 357-1632
Entity
Organization
Contact information
Practice address
2300 N IMPERIAL AVE, CALEXICO, CA 92231-3209
(760) 357-1632
Mailing address
2300 N IMPERIAL AVE, CALEXICO, CA 92231-3209
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
52739
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G8975101
—
CA
Enumeration date
04/22/2008
Last updated
04/22/2008
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