| Keon-jung Kim Dental Corporation | |
|
2492 Walnut Ave Ste 200 Tustin CA 92780-6960 | |
| (949) 679-6000 | |
| (949) 679-6001 |
| Full Name | Keon-jung Kim Dental Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2492 Walnut Ave Ste 200, Tustin, California |
| Authorized Official Name and Position | Keon-jung Kim (OWNER) |
| Authorized Official Contact | 9496796000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keon-jung Kim Dental Corporation 2492 Walnut Ave Ste 200 Tustin CA 92780-6960 Ph: (949) 679-6000 | Keon-jung Kim Dental Corporation 2492 Walnut Ave Ste 200 Tustin CA 92780-6960 Ph: (949) 679-6000 |
| NPI Number | 1932315298 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932315298 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 47919 (California) | Primary |
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