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General NPI Number Information
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NPI Number | 1609427699
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Entity Type | Organization
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Legal Business Name | MS DENTAL PLLC
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Dates
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Enumeration Date | 09/22/2019
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 8821 METROPARK DR STE 1500
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City | SHENANDOAH
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State | TX
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Zip | 77385-6215
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Country | US
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Telephone | 617-281-3189
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Fax |
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Provider Business Mailing Address
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Address Line | 114 WILD GARDEN CT
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City | CONROE
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State | TX
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Zip | 77304-5094
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Country | US
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Telephone | 617-281-3189
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KENNETH KIM
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Credential | DMD
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Telephone | 281-501-7770
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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 |
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License Number State |
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