Brian Songsu Kim

Organization Active NPI General Practice Dentistry · Wasco, CA

NPI 1881801975 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1881801975
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
BRIAN SONGSU KIM
Practice address
1245 7TH St
Wasco, CA 93280-1820
Phone
(661) 758-3021
Fax
(661) 758-6980
NPI assigned
May 17, 2007
Organization subpart
No

Authorized official

Name
Sylvia Garza
Title
Office Manager
Phone
(661) 758-3021

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Brian Songsu Kim (3 organizations share this tax ID)

Locations

1245 7th St
Wasco, CA 93280
Phone (661) 758-3021

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

1245 7TH St
Wasco, CA 93280-1820

Mailing address

1245 7TH St
Wasco, CA 93280-1820
Phone (661) 758-3021

Other names

  • HOMETOWN DENTAL CARE Doing business as

Other providers in Wasco, CA

All providers in Wasco, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.