| Brian J. Kim, Dds, Msd, Inc. | |
|
10515 Balboa Blvd Suite 280 Granada Hills CA 91344-6343 | |
| (818) 363-7900 | |
| (818) 368-7111 |
| Full Name | Brian J. Kim, Dds, Msd, Inc. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 10515 Balboa Blvd, Granada Hills, California |
| Authorized Official Name and Position | Brian Kim (PRESIDENT) |
| Authorized Official Contact | 8183637900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian J. Kim, Dds, Msd, Inc. 10515 Balboa Blvd Suite 280 Granada Hills CA 91344-6343 Ph: (818) 363-7900 | Brian J. Kim, Dds, Msd, Inc. 10515 Balboa Blvd Suite 280 Granada Hills CA 91344-6343 Ph: (818) 363-7900 |
| NPI Number | 1689862617 |
|---|---|
| Provider Enumeration Date | 10/03/2007 |
| Last Update Date | 10/03/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689862617 | NPI | - | NPPES |
| 248133 | Other | CA | DELTA DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 48133 (California) | Primary |
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