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General NPI Number Information
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NPI Number | 1093115438
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Entity Type | Organization
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Legal Business Name | KITE DENTAL PLLC
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 701 N CENTRAL EXPY BLDG #4
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City | RICHARDSON
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State | TX
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Zip | 75080
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Country | US
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Telephone | 469-291-7023
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Fax | 469-291-7023
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Provider Business Mailing Address
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Address Line | 701 N CENTRAL EXPY BLDG #4
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City | RICHARDSON
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State | TX
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Zip | 75080
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Country | US
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Telephone | 469-291-7023
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Fax | 469-291-7023
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Authorized Official
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Title or Position | OWNER
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Name | DR. HYUNGCHUL CHUL KIM
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Credential | DDS
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Telephone | 469-291-7023
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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 | 29373
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License Number State | TX
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