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Organization

CHARLES C. KIM, D.D.S., INC.

Active
Other names
Waterford Family Dentist, Dental Practice of Dr. Charles C. Kim, DDS
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES CHANWOONG KIM DDS (CEO, OWNER)
(209) 874-2337
Entity
Organization

Contact information

Practice address
12142 YOSEMITE BLVD, WATERFORD, CA 95386-9163
(209) 874-2337
(209) 874-9822
Mailing address
12142 YOSEMITE BLVD, WATERFORD, CA 95386-9163
(209) 874-2337
(209) 874-9822

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61112
CA

Other

Enumeration date
04/18/2016
Last updated
04/18/2016
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