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General NPI Number Information
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NPI Number | 1790934354
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Entity Type | Organization
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Legal Business Name | DR. JANET C. LIM , D.M.D
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 112 PARK PLACE
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City | MILLBRAE
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State | CA
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Zip | 94030-1235
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Country | US
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Telephone | 650-588-3080
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Fax | 650-588-3081
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Provider Business Mailing Address
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Address Line | 112 PARK PL
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City | MILLBRAE
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State | CA
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Zip | 94030-1235
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Country | US
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Telephone | 650-588-3080
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Fax | 650-588-3081
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JANET C. LIM
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Credential | D.M.D.
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Telephone | 650-588-3080
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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 | 44972
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License Number State | CA
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