Organization
KIM SHIMAZU & LEE DENTAL CORP
Active
Other names
Ivy Endodontic Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL HWANGSUK KIM DDS (OWNER)
(714) 530-7888
Entity
Organization
Contact information
Practice address
12865 MAIN ST STE #201, GARDEN GROVE, CA 92840
(714) 530-7888
(714) 530-1344
Mailing address
12865 MAIN ST STE #201, GARDEN GROVE, CA 92840
(714) 530-7888
(714) 530-1344
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
36953
CA
Other
Enumeration date
08/25/2006
Last updated
08/22/2020
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