Individual
DR. JEONG DOO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D, D.D.S
Contact information
Practice address
4000 TYLER ST STE A, RIVERSIDE, CA 92503-3458
(951) 687-4460
(951) 687-7448
Mailing address
20505 VIA TENORIO, YORBA LINDA, CA 92887-3239
(310) 713-5159
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
50622
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
A102220
CA
Other
Enumeration date
05/11/2007
Last updated
10/18/2012
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