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General NPI Number Information
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NPI Number | 1275775082
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Entity Type | Organization
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Legal Business Name | GEORGE D. LIM, DMD, INC.
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Dates
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Enumeration Date | 03/26/2009
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 401 S FAIRFAX AVE
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City | LOS ANGELES
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State | CA
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Zip | 90036-3133
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Country | US
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Telephone | 323-951-0814
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Fax |
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Provider Business Mailing Address
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Address Line | 401 S FAIRFAX AVE
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City | LOS ANGELES
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State | CA
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Zip | 90036-3133
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Country | US
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Telephone | 323-951-0814
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Fax |
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Authorized Official
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Title or Position | HR ADMIN/ACCOUNTS
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Name | MRS. MILAGROS L. LIM
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Credential |
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Telephone | 323-951-0814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 43190
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License Number State | CA
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