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General NPI Number Information
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NPI Number | 1730704495
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Entity Type | Organization
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Legal Business Name | JUNG AND 3KIMS DENTAL GROUP
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 1535 E HIGHLAND AVE STE F
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-4682
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Country | US
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Telephone | 909-356-6852
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Fax |
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Provider Business Mailing Address
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Address Line | 1535 E HIGHLAND AVE STE F
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-4682
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGIONAL MANAGER
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Name | SANDRA RANGEL
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Credential |
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Telephone | 909-453-0244
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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 |
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License Number State |
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