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General NPI Number Information
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NPI Number | 1386971000
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Entity Type | Individual
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Provider Name | JULIE YONGSOOK KIM D.D.S
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Gender | Female
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 05/25/2010
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Provider Practice Location Address
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Address Line | 7841 COMMONWEALTH AVE
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City | BUENA PARK
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State | CA
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Zip | 90621-2422
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Country | US
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Telephone | 714-739-7173
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Fax |
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Provider Business Mailing Address
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Address Line | 2882 MUIR TRAIL DR
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City | FULLERTON
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State | CA
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Zip | 92833-5516
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Country | US
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Telephone | 562-505-6301
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 58033
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License Number State | CA
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