| |
41250 12th St W Suite A Palmdale CA 93551-1444 | |
(661) 267-0617 | |
(661) 267-0621 |
Full Name | |
---|---|
Speciality | Dentist - Endodontics |
Location | 41250 12th St W, Palmdale, California |
Authorized Official Name and Position | Jung Lim (OWNER) |
Authorized Official Contact | 6612670617 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
41250 12th St W Suite A Palmdale CA 93551-1444 Ph: (661) 267-0617 | 41250 12th St W Suite A Palmdale CA 93551-1444 Ph: (661) 267-0617 |
NPI Number | 1972770600 |
---|---|
Provider Enumeration Date | 05/12/2008 |
Last Update Date | 07/23/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972770600 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223E0200X | Dentist - Endodontics | 48499 (California) | Primary |