Waterford Family Dentist, Dental Practice Of Dr. Charles C. Kim, Dds | |
12142 Yosemite Blvd Waterford CA 95386-9163 | |
(209) 874-2337 | |
(209) 874-9822 |
Full Name | Waterford Family Dentist, Dental Practice Of Dr. Charles C. Kim, Dds |
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Speciality | Dentist - General Practice |
Location | 12142 Yosemite Blvd, Waterford, California |
Authorized Official Name and Position | Charles Chanwoong Kim (CEO, OWNER) |
Authorized Official Contact | 2098742337 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Waterford Family Dentist, Dental Practice Of Dr. Charles C. Kim, Dds 12142 Yosemite Blvd Waterford CA 95386-9163 Ph: (209) 874-2337 | Waterford Family Dentist, Dental Practice Of Dr. Charles C. Kim, Dds 12142 Yosemite Blvd Waterford CA 95386-9163 Ph: (209) 874-2337 |
NPI Number | 1437503356 |
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Provider Enumeration Date | 04/18/2016 |
Last Update Date | 04/18/2016 |
Identifier | Type | State | Issuer |
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1437503356 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 61112 (California) | Primary |