NPI: 1437503356
Provider Name: CHARLES C. KIM, D.D.S., INC.
Doing Business As: WATERFORD FAMILY DENTIST, DENTAL PRACTICE OF DR. CHARLES C. KIM, DDS
Classification: Dentist - 1223G0001X
Entity Type: Organization
Specialization: General Practice
CLIA Number: 05D2079717
Address:
12142 YOSEMITE BLVD
WATERFORD, CA
ZIP 95386
Phone: (209) 874-2337
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CHARLES C. KIM, D.D.S., INC. is a general practice dentist in Waterford, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CHARLES C. KIM, D.D.S., INC. NPI is 1437503356. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Waterford Family Dentist, Dental Practice Of Dr. Charles C. Kim, Dds.
The provider's business location address is:
12142 YOSEMITE BLVD
WATERFORD, CA
ZIP 95386-163
Phone: (209) 874-2337
Fax: (209) 874-9822
The provider's authorized official is Charles Chanwoong Kim .
The authorized official title is Ceo, Owner and has the following contact phone number (209) 874-2337.
The CLIA number assigned to this NPI record is 05D2079717 - rural health clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 4/18/2016 and was last updated on 4/18/2016.