Provider Demographics
NPI:1982822045
Name:LIM, VINCENT PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:PATRICK
Last Name:LIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 ADMIRAL CALLAGHAN LN
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-4000
Mailing Address - Country:US
Mailing Address - Phone:707-552-3816
Mailing Address - Fax:707-552-3847
Practice Address - Street 1:41 ADMIRAL CALLAGHAN LN
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-4000
Practice Address - Country:US
Practice Address - Phone:707-552-3816
Practice Address - Fax:707-552-3847
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52638122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist