Individual
AUDREY BORAHM KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1ST DENTAL BATTALION/NAVAL DENTAL CENTER, ATTN: MEDICAL STAFF SVES; BLDG 2238 A AVE, CAMP PENDLETON, CA 92055-5221
(818) 939-1914
Mailing address
56869 ANTELOPE TRL APT 6, YUCCA VALLEY, CA 92284-2871
(818) 939-1914
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
105474
CA
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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