MEDICARE: DR. SOY MUOY LIM DDS

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
1	1223G0001X	General Practice Dentistry	58458	CA

General Provider Information

NPI Number	:	1942430749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SOY MUOY LIM DDS

Provider Business Mailing Address
First Line	:	2041 CHARLEMAGNE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-2928
Country	:	US
Telephone Number	:	562-301-7998
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 CHARLEMAGNE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-2928
Country	:	US
Telephone Number	:	562-301-7998
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2009
Last Update Date	:	07/15/2009

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