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NPI Code Detail

MEDICARE: LEE & KIM, DDS, INC

MEDICARE: LEE & KIM, DDS, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice PhysicianCA

General Provider Information

NPI Number : 1023268083
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEE & KIM, DDS, INC
Provider Business Mailing Address
First Line : 13031 KERRY ST
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92844-1638
Country : US
Telephone Number : 714-638-2141
Fax Number :
Provider Business Practice Location Address
First Line : 13031 KERRY ST
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92844-1638
Country : US
Telephone Number : 714-638-2141
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. DONG MYUNG KIM
Credential : DDS
Telephone Number : 714-638-4042
Provider Enumeration Date : 09/26/2008
Last Update Date : 09/26/2008

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Directions to “LEE & KIM, DDS, INC ” Practice Location

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