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General NPI Number Information
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NPI Number | 1881929396
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Entity Type | Organization
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Legal Business Name | BRIAN T. KIM, DDS, INC.
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Dates
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Enumeration Date | 10/16/2009
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Last Update Date | 10/16/2009
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Provider Practice Location Address
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Address Line | 7501 HOSPITAL DR STE 202
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City | SACRAMENTO
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State | CA
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Zip | 95823-5405
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Country | US
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Telephone | 916-682-9031
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Fax |
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Provider Business Mailing Address
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Address Line | 7501 HOSPITAL DR STE 202
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City | SACRAMENTO
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State | CA
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Zip | 95823-5405
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Country | US
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Telephone | 916-682-9031
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. BRIAN T KIM
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Credential |
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Telephone | 916-682-9031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 50625
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License Number State | CA
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