| Dr Kim Dental Corporation | |
|
651 S Beach Blvd La Habra CA 90631-5854 | |
| (562) 691-3697 | |
| Not Available |
| Full Name | Dr Kim Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 651 S Beach Blvd, La Habra, California |
| Authorized Official Name and Position | Seung Hwan Kim (CEO/PRESIDENT) |
| Authorized Official Contact | 2135052088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kim Dental Corporation 651 S Beach Blvd La Habra CA 90631-5854 Ph: () - | Dr Kim Dental Corporation 651 S Beach Blvd La Habra CA 90631-5854 Ph: (562) 691-3697 |
| NPI Number | 1952874810 |
|---|---|
| Provider Enumeration Date | 01/03/2019 |
| Last Update Date | 01/03/2019 |
| Medicare PECOS PAC ID | 5496088122 |
|---|---|
| Medicare Enrollment ID | O20190611002622 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952874810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Seung Hwan Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1972964260 PECOS PAC ID: 3476808320 Enrollment ID: I20180616000031 |
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