| Louis M Kim, A Professional Dental Corporation | |
|
1824 Avondale Ave Sacramento CA 95825-1378 | |
| (916) 900-8521 | |
| (916) 900-8526 |
| Full Name | Louis M Kim, A Professional Dental Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1824 Avondale Ave, Sacramento, California |
| Authorized Official Name and Position | Louis Kim (OWNER/DENTIST) |
| Authorized Official Contact | 9169008521 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louis M Kim, A Professional Dental Corporation 1824 Avondale Ave Sacramento CA 95825-1378 Ph: (916) 900-8521 | Louis M Kim, A Professional Dental Corporation 1824 Avondale Ave Sacramento CA 95825-1378 Ph: (916) 900-8521 |
| NPI Number | 1104336478 |
|---|---|
| Provider Enumeration Date | 10/02/2017 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104336478 | NPI | - | NPPES |
| 1174711522 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 53231 (California) | Primary |
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