Organization
AMY KIM DMD INC.
Active
Other names
Eastvale Kids Dental Studio
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMY KIM DMD (OWNER DENTIST)
(909) 270-6602
Entity
Organization
Contact information
Practice address
14252 SCHLEISMAN RD STE 102, EASTVALE, CA 92880-4026
(951) 507-1073
(951) 507-1332
Mailing address
14252 SCHLEISMAN RD STE 102, EASTVALE, CA 92880-4026
(951) 507-1073
(951) 507-1332
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110739
DENTAL LICENSE
CA
Enumeration date
02/24/2025
Last updated
02/24/2025
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