Provider Demographics
NPI:1700277845
Name:LEE AND KIM DENTAL CORPORATION
Entity Type:Organization
Organization Name:LEE AND KIM DENTAL CORPORATION
Other - Org Name:SMILE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:MR
Authorized Official - First Name:DONG
Authorized Official - Middle Name:M
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-924-3334
Mailing Address - Street 1:17334 PIONEER BLVD
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-2708
Mailing Address - Country:US
Mailing Address - Phone:562-925-3334
Mailing Address - Fax:562-809-3007
Practice Address - Street 1:17334 PIONEER BLVD
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-2708
Practice Address - Country:US
Practice Address - Phone:562-925-3334
Practice Address - Fax:562-809-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental