Individual
DR. JILLIAN LIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D., M.S.
Contact information
Practice address
2331 WARMOUTH ST, SAN PEDRO, CA 90732-4534
(917) 650-0304
Mailing address
2331 WARMOUTH ST, SAN PEDRO, CA 90732-4534
(917) 650-0304
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0444481
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DDS101070
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01516632
—
NY
Enumeration date
08/16/2007
Last updated
04/20/2023
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