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General NPI Number Information
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NPI Number | 1396944492
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Entity Type | Organization
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Legal Business Name | KIM LUU D.D.S. INC.
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 991 MONTAGUE EXPY STE 202
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City | MILPITAS
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State | CA
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Zip | 95035-6819
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Country | US
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Telephone | 408-263-3090
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Fax |
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Provider Business Mailing Address
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Address Line | 991 MONTAGUE EXPY STE 202
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City | MILPITAS
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State | CA
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Zip | 95035-6819
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Country | US
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Telephone | 408-263-3090
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KIM LUU
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Credential | D.D.S.
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Telephone | 408-263-3090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 50638
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License Number State | CA
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