MEDICARE: FRANCES KIM DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0001X	Public Health Dentistry	DN20236	MA

General Provider Information

NPI Number	:	1366941338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCES KIM DDS

Provider Business Mailing Address
First Line	:	PO BOX 340767
Second Line	:
City	:	JBSA FT SAM HOUSTON
State	:	TX
Zip	:	78234-0767
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2791 N NEW BRAUNFELS AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78234-2664
Country	:	US
Telephone Number	:	210-278-8083
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2018
Last Update Date	:	02/06/2018

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