| Keon-jung Kim Professional Dental Corporation | |
|
3257 Camino De Los Coches #303 Carlsbad CA 92009-8966 | |
| (760) 479-9876 | |
| (760) 479-0028 |
| Full Name | Keon-jung Kim Professional Dental Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3257 Camino De Los Coches, Carlsbad, California |
| Authorized Official Name and Position | Keon-jung Kim (OWNER) |
| Authorized Official Contact | 7604799876 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keon-jung Kim Professional Dental Corporation 3257 Camino De Los Coches #303 Carlsbad CA 92009-8966 Ph: (760) 479-9876 | Keon-jung Kim Professional Dental Corporation 3257 Camino De Los Coches #303 Carlsbad CA 92009-8966 Ph: (760) 479-9876 |
| NPI Number | 1114132107 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 08/23/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114132107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 47919 (California) | Primary |
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