Organization
ELLEN IM DDS INC
Active
Other names
Dr. Ellen Im Pediatric Dentistry and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLEN IM DDS (OWNER/OPERATOR)
(858) 679-6660
Entity
Organization
Contact information
Practice address
13422 POMERADO RD STE 201, POWAY, CA 92064-3548
(858) 679-6660
Mailing address
13422 POMERADO RD STE 201, POWAY, CA 92064-3548
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
10/21/2020
Last updated
05/06/2021
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