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General NPI Number Information
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NPI Number | 1861389157
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Entity Type | Individual
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Provider Name | YONGWOO LIM DDS
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Gender | Male
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 1060 S HARRISON RD STE 110
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City | TUCSON
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State | AZ
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Zip | 85748-6603
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Country | US
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Telephone | 520-917-0666
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Fax |
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Provider Business Mailing Address
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Address Line | 9125 E CATALINA HWY UNIT 178
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City | TUCSON
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State | AZ
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Zip | 85749-6912
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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 |
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Name |
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Credential |
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Telephone |
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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 | D012575
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License Number State | AZ
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