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19333 Bear Valley Rd Ste 205 Apple Valley CA 92308-5150 | |
(760) 247-4155 | |
(760) 247-4955 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 19333 Bear Valley Rd Ste 205, Apple Valley, California |
Authorized Official Name and Position | Anne Sooyun Kim (CEO) |
Authorized Official Contact | 7602474155 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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19333 Bear Valley Rd Ste 205 Apple Valley CA 92308-5150 Ph: (760) 247-4155 | 19333 Bear Valley Rd Ste 205 Apple Valley CA 92308-5150 Ph: (760) 247-4155 |
NPI Number | 1194273102 |
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Provider Enumeration Date | 09/19/2016 |
Last Update Date | 09/19/2016 |
Identifier | Type | State | Issuer |
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1194273102 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 55536 (California) | Primary |
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