Individual
JA YOUNG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
345 E 24TH ST, NEW YORK, NY 10010-4020
(212) 998-9880
Mailing address
13362 WOODLAND DR, TUSTIN, CA 92780-4762
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DDS110670
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2023
Last updated
10/04/2024
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