| Charles C. Kim, D.d.s., Inc. | |
| 
					12142 Yosemite Blvd Waterford CA 95386-9163  | |
| (209) 874-2337 | |
| (209) 874-9822 | 
| Full Name | Charles C. Kim, D.d.s., Inc. | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 12142 Yosemite Blvd, Waterford, California | 
| Authorized Official Name and Position | Charles Chanwoong Kim (CEO, OWNER) | 
| Authorized Official Contact | 2098742337 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Charles C. Kim, D.d.s., Inc. 12142 Yosemite Blvd Waterford CA 95386-9163 Ph: (209) 874-2337  | Charles C. Kim, D.d.s., Inc. 12142 Yosemite Blvd Waterford CA 95386-9163 Ph: (209) 874-2337  | 
| NPI Number | 1437503356 | 
|---|---|
| Provider Enumeration Date | 04/18/2016 | 
| Last Update Date | 04/18/2016 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1437503356 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 61112 (California) | Primary |