Individual
DR. BRIAN JONGYOON KIM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D.
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
06/06/2006
Last updated
07/08/2007
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