Provider Demographics
NPI:1750557054
Name:LIM, JUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:JUNG
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:73950 ALESSANDRO DR
Mailing Address - Street 2:SUITE #6
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-3637
Mailing Address - Country:US
Mailing Address - Phone:760-340-3341
Mailing Address - Fax:760-340-1088
Practice Address - Street 1:73950 ALESSANDRO DR
Practice Address - Street 2:SUITE #6
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3637
Practice Address - Country:US
Practice Address - Phone:760-340-3341
Practice Address - Fax:760-340-1088
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA520791223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics