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General NPI Number Information
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NPI Number | 1568853398
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Entity Type | Organization
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Legal Business Name | EUKYEOM KIM DDS PLLC
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Dates
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Enumeration Date | 02/16/2015
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Last Update Date | 02/16/2015
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Provider Practice Location Address
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Address Line | 13998 HORIZON BLVD #140
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City | HORIZON CITY
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State | TX
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Zip | 79928
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Country | US
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Telephone | 323-381-0383
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Fax |
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Provider Business Mailing Address
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Address Line | 362 EMERALD WOODS
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City | EL PASO
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State | TX
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Zip | 79928
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | D.D.S
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Name | EUKYEOM KIM
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Credential |
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Telephone | 323-381-0383
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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 | 27859
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License Number State | TX
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