Individual
DR. JAE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
65151
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12130
CT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
65151
CA
Other
Enumeration date
10/28/2015
Last updated
03/17/2018
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