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General NPI Number Information
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NPI Number | 1609366582
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Entity Type | Organization
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Legal Business Name | KIWON YOUN DDS INC
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 18250 COLIMA RD. #201
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-2618
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Country | US
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Telephone | 626-964-2875
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Fax | 626-964-1033
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Provider Business Mailing Address
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Address Line | 18250 COLIMA RD. #201
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-2618
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Country | US
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Telephone | 626-964-2875
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Fax | 626-964-1033
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Authorized Official
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Title or Position | CEO
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Name | KIWON YOUN
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Credential | D.D.S
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Telephone | 626-964-2875
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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 | 64609
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License Number State | CA
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