Organization
GHIM PROFESSIONAL CORPORATION
Active
Other names
Black Mountain Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEEYUP GHIM D.M.D. (PRESIDENT)
(702) 564-4498
Entity
Organization
Contact information
Practice address
270 E HORIZON DR, SUITE 106, HENDERSON, NV 89015-8036
(702) 564-4498
Mailing address
840 VALLEY BRUSH ST, HENDERSON, NV 89052-3813
(702) 564-4498
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4848
NV
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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