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NPI Code Detail

MEDICARE: HEE JUNG KIM DMD

MEDICARE: HEE JUNG KIM DMD
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
11223G0001XGeneral Practice Dentistry31214TX

General Provider Information

NPI Number : 1467836536
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEE JUNG KIM DMD
Provider Business Mailing Address
First Line : 3030 LBJ FWY STE 1400
Second Line :
City : DALLAS
State : TX
Zip : 75234-2766
Country : US
Telephone Number : 972-663-5353
Fax Number :
Provider Business Practice Location Address
First Line : 3030 LBJ FWY STE 1400
Second Line :
City : DALLAS
State : TX
Zip : 75234-2766
Country : US
Telephone Number : 972-663-5353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2015
Last Update Date : 07/17/2015

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Directions to “ HEE JUNG KIM DMD” Practice Location

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