Organization
BRIAN J. KIM, DDS, MSD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN KIM D.D.S., M.S.D. (PRESIDENT)
(818) 363-7900
Entity
Organization
Contact information
Practice address
10515 BALBOA BLVD, SUITE 280, GRANADA HILLS, CA 91344-6343
(818) 363-7900
(818) 368-7111
Mailing address
10515 BALBOA BLVD, SUITE 280, GRANADA HILLS, CA 91344-6343
(818) 363-7900
(818) 368-7111
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
48133
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
248133
DELTA DENTAL
CA
Enumeration date
10/03/2007
Last updated
10/03/2007
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