Individual
KELLY YEON SU KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
30001 CROWN VALLEY PKWY, SUITE G, LAGUNA NIGUEL, CA 92677-1723
(949) 495-4245
Mailing address
30001 CROWN VALLEY PKWY, SUITE G, LAGUNA NIGUEL, CA 92677-1723
(949) 495-4245
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
055114
NY
1223P0221X
Pediatric Dentistry
Primary
58075
CA
Other
Enumeration date
08/04/2010
Last updated
06/16/2011
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