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Individual

DR. TERI LY KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
747 52ND ST., OAKLAND, CA 94609
(510) 964-0168
Mailing address
P.O. BOX 22210, OAKLAND, CA 94623-2210
(510) 535-4000
(510) 535-4128

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
13802
MD
1223P0221X
Pediatric Dentistry
Primary
55811
CA

Other

Enumeration date
11/01/2006
Last updated
02/08/2012
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