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NPI Code Detail

MEDICARE: KIM LEMIRE, DMD INC.

MEDICARE: KIM LEMIRE, DMD INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
161461OTHERCADENTIST

General Provider Information

NPI Number : 1962086728
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIM LEMIRE, DMD INC.
Provider Business Mailing Address
First Line : 1537 LOMITA BLVD
Second Line :
City : HARBOR CITY
State : CA
Zip : 90710-2024
Country : US
Telephone Number : 310-530-5252
Fax Number : 310-530-6922
Provider Business Practice Location Address
First Line : 1537 LOMITA BLVD
Second Line :
City : HARBOR CITY
State : CA
Zip : 90710-2024
Country : US
Telephone Number : 310-530-5252
Fax Number : 310-530-6922
Authorized Official
Title or Position : OWNER DENTIST
Name : DR. KIM LEMIRE
Credential : DMD
Telephone Number : 310-530-5252
Provider Enumeration Date : 05/07/2021
Last Update Date : 05/07/2021

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