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Individual

SHIN JOSEPH KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
13128 14TH STREET, CAMP PENDLETON, CA 92058
(760) 763-1126
Mailing address
1234 BELLINGHAM DR, OCEANSIDE, CA 92057-2723
(818) 523-7253

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
7764010-9921-2014040
UT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DDS107230
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN28761
FL

Other

Enumeration date
03/26/2010
Last updated
01/19/2024
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