Organization
CHARLES KIM DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES KIM D.D.S. (OWNER DENTIST)
(562) 943-3794
Entity
Organization
Contact information
Practice address
15651 IMPERIAL HWY STE 204, LA MIRADA, CA 90638-1653
(562) 943-3794
Mailing address
15651 IMPERIAL HWY STE 204, LA MIRADA, CA 90638-1653
(562) 943-3794
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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