Individual
KIM-SA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2121 MALCOLM AVE, LOS ANGELES, CA 90025-6305
(714) 369-9426
Mailing address
2121 MALCOLM AVE, LOS ANGELES, CA 90025-6305
(714) 369-9426
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
112367
CA
Other
Enumeration date
03/16/2026
Last updated
03/16/2026
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