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General NPI Number Information
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NPI Number | 1073013819
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Entity Type | Organization
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Legal Business Name | SHK ENTERPRISE
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Dates
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Enumeration Date | 02/19/2018
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Last Update Date | 02/19/2018
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Provider Practice Location Address
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Address Line | 11875 COIT RD STE 120
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City | FRISCO
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State | TX
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Zip | 75035
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Country | US
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Telephone | 214-387-0405
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Fax | 214-387-0406
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Provider Business Mailing Address
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Address Line | 11875 COIT RD STE 120
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City | FRISCO
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State | TX
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Zip | 75035
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Country | US
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Telephone | 214-387-0405
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Fax | 214-387-0406
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUNG KIM
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Credential | DDS
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Telephone | 214-387-0405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28142
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License Number State | TX
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