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General NPI Number Information
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NPI Number | 1417138181
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Entity Type | Organization
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Legal Business Name | YONG AND KIM DENTAL CORP.
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 11/21/2007
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Provider Practice Location Address
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Address Line | 101 E LINCOLN AVE STE.100
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City | ANAHEIM
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State | CA
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Zip | 92805-3202
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Country | US
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Telephone | 714-535-0192
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Fax |
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Provider Business Mailing Address
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Address Line | 101 E LINCOLN AVE STE.100
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City | ANAHEIM
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State | CA
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Zip | 92805-3202
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Country | US
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Telephone | 714-535-0192
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RICHARD JUNG YONG
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Credential | D.D.S.
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Telephone | 714-535-0192
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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 | 47591
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License Number State | CA
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