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General NPI Number Information
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NPI Number | 1225357346
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Entity Type | Individual
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Provider Name | KWANGSEOK AHN DDS,MS.
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Gender | Male
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Dates
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Enumeration Date | 05/28/2010
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Last Update Date | 02/26/2015
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Provider Practice Location Address
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Address Line | 3420 K AVE STE 140
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City | PLANO
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State | TX
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Zip | 75074-2333
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Country | US
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Telephone | 734-747-1804
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Fax |
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Provider Business Mailing Address
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Address Line | 3103 BAINBRIDGE LN
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City | FRISCO
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State | TX
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Zip | 75034-0778
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Country | US
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Telephone | 734-747-1804
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 25377
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License Number State | TX
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