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General NPI Number Information
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NPI Number | 1497183065
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER J. KIM, DDS, INC.
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Dates
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Enumeration Date | 10/17/2013
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Last Update Date | 10/17/2013
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Provider Practice Location Address
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Address Line | 2486 W. EL CAMINO REAL
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040
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Country | US
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Telephone | 650-559-8882
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Fax | 650-559-8887
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Provider Business Mailing Address
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Address Line | 2486 W. EL CAMINO REAL
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040
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Country | US
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Telephone | 650-559-8882
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Fax | 650-559-8887
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CHRISTOPHER JUNG KWON KIM
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Credential | D.D.S., ME
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Telephone | 650-559-8882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 43802
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License Number State | CA
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