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General NPI Number Information
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NPI Number | 1144882978
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Entity Type | Organization
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Legal Business Name | JOSEPH J. KIM, DDS, INC.
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 07/02/2019
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Provider Practice Location Address
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Address Line | 72415 PARKVIEW DR
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City | PALM DESERT
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State | CA
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Zip | 92260-2779
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Country | US
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Telephone | 760-568-5928
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Fax |
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Provider Business Mailing Address
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Address Line | 35948 MICHELLE LN
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City | BEAUMONT
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State | CA
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Zip | 92223-1649
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Country | US
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Telephone | 909-430-1973
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH KIM
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Credential |
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Telephone | 909-430-1973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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