Organization
EASTSHORE PEDIATRIC DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERI L KIM DDS (CO-OWNER)
(916) 792-9267
Entity
Organization
Contact information
Practice address
2000 APPIAN WAY STE 303, PINOLE, CA 94564-2525
(510) 964-0168
Mailing address
2000 APPIAN WAY STE 303, PINOLE, CA 94564-2525
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
55811
CA
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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