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General NPI Number Information
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NPI Number | 1578736872
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Entity Type | Organization
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Legal Business Name | MIN SEOK KIM DDS INC
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 04/12/2019
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Provider Practice Location Address
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Address Line | 3680 WILSHIRE BLVD STE 210
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City | LOS ANGELES
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State | CA
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Zip | 90010-2713
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Country | US
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Telephone | 213-739-8855
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Fax | 213-739-8899
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Provider Business Mailing Address
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Address Line | 3680 WILSHIRE BLVD STE 210
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City | LOS ANGELES
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State | CA
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Zip | 90010-2713
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Country | US
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Telephone | 213-739-8855
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Fax | 213-739-8899
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIN SEOK KIM
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Credential | D.M.D.
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Telephone | 213-249-2319
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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 | 54166
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License Number State | CA
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