| Youngkwun Kim Dds Inc | |
|
8110 Mango Ave Ste 101 Fontana CA 92335-3603 | |
| (909) 829-9324 | |
| Not Available |
| Full Name | Youngkwun Kim Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 8110 Mango Ave Ste 101, Fontana, California |
| Authorized Official Name and Position | Young Kwun Kim (CEO) |
| Authorized Official Contact | 9098299324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Youngkwun Kim Dds Inc 8110 Mango Ave Ste 101 Fontana CA 92335-3603 Ph: (909) 829-9324 | Youngkwun Kim Dds Inc 8110 Mango Ave Ste 101 Fontana CA 92335-3603 Ph: (909) 829-9324 |
| NPI Number | 1982067229 |
|---|---|
| Provider Enumeration Date | 04/04/2016 |
| Last Update Date | 04/05/2016 |
| Medicare PECOS PAC ID | 4587925706 |
|---|---|
| Medicare Enrollment ID | O20180305002079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982067229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 58389 (California) | Primary |
| Provider Name | Young Kwun Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1215264098 PECOS PAC ID: 5496016610 Enrollment ID: I20180305002126 |
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