| Michelle K. Kim D.d.s. Corp. | |
|
2245 E. Colorado Blvd. Suite 201 Pasadena CA 91107 | |
| (626) 449-3367 | |
| (626) 449-3376 |
| Full Name | Michelle K. Kim D.d.s. Corp. |
|---|---|
| Speciality | Dentist |
| Location | 2245 E. Colorado Blvd., Pasadena, California |
| Authorized Official Name and Position | Michelle Kyongah Kim (PRESIDENT/OWNER) |
| Authorized Official Contact | 6264493367 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle K. Kim D.d.s. Corp. 2245 E. Colorado Blvd. Suite 201 Pasadena CA 91107 Ph: (626) 449-3367 | Michelle K. Kim D.d.s. Corp. 2245 E. Colorado Blvd. Suite 201 Pasadena CA 91107 Ph: (626) 449-3367 |
| NPI Number | 1295979532 |
|---|---|
| Provider Enumeration Date | 04/30/2009 |
| Last Update Date | 08/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295979532 | NPI | - | NPPES |
| B42670-01 | Other | CA | MEDICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 122300000X | Dentist | 42670 (California) | Primary |
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