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4112 East Renner Rd. Richardson TX 75082 | |
(972) 480-0800 | |
(972) 480-0900 |
Full Name | |
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Speciality | Dentist - Prosthodontics |
Location | 4112 East Renner Rd., Richardson, Texas |
Authorized Official Name and Position | Jinsoo Kim (PRESIDENT) |
Authorized Official Contact | 9724800800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4112 East Renner Rd. Richardson TX 75082 Ph: (972) 480-0800 | 4112 East Renner Rd. Richardson TX 75082 Ph: (972) 480-0800 |
NPI Number | 1083096713 |
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Provider Enumeration Date | 06/18/2015 |
Last Update Date | 06/18/2015 |
Identifier | Type | State | Issuer |
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1083096713 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223P0700X | Dentist - Prosthodontics | 28842 (Texas) | Primary |
Richardson Oral Surgery And Implant Center Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1070 W Campbell Rd, Suite 200, Richardson, TX 75080 Phone: 972-231-6661 Fax: 972-231-3161 | |
Jay L. Nutt & C. Fred Pietsch, Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1231 E Belt Line Rd, Suite 103, Richardson, TX 75081 Phone: 972-690-8617 Fax: 972-690-6423 | |