Individual
JI LIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
(215) 456-6620
Mailing address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
108483
CA
1223G0001X
General Practice Dentistry
10812
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2016
Last updated
05/22/2024
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