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HA JUNG KIM

>> Dentist >> Dental Providers

Registrant NPI Number: 1275772063

Individual Registrant:
 HA JUNG  KIM 
Gender: F
Sole Proprietor

Location and contact information for practice:
851 5TH ST STE H  GONZALES, CA 93926-9437 US
Tel: 831-240-0865  Fax: --

Contact information for business:
851 5TH ST STE H  GONZALES, CA 93926-9437 US
Tel: --  Fax: --

Registration Information:
NPI: 1275772063
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
CA54710
N1223G0001XDental Providers
Dentist
CA54710
N122300000XDental Providers
Dentist
OH30-022952

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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