| Dr. Kim's Dental, Inc | |
|
2216 Royal Ln 115 Dallas TX 75229-7814 | |
| (972) 243-0365 | |
| (972) 247-0898 |
| Full Name | Dr. Kim's Dental, Inc |
|---|---|
| Speciality | Dentist |
| Location | 2216 Royal Ln, Dallas, Texas |
| Authorized Official Name and Position | Soon Ki Kim (PRESIDENT) |
| Authorized Official Contact | 9723991466 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Kim's Dental, Inc 2216 Royal Ln 115 Dallas TX 75229-7814 Ph: (972) 243-0365 | Dr. Kim's Dental, Inc 2216 Royal Ln 115 Dallas TX 75229-7814 Ph: (972) 243-0365 |
| NPI Number | 1649593971 |
|---|---|
| Provider Enumeration Date | 03/01/2010 |
| Last Update Date | 09/17/2013 |
| Medicare PECOS PAC ID | 5698097996 |
|---|---|
| Medicare Enrollment ID | O20141121001925 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649593971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 23100 (Texas) | Primary |
| Provider Name | Soonki Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1225151186 PECOS PAC ID: 0345480885 Enrollment ID: I20130708000027 |
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