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General NPI Number Information
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NPI Number | 1780845016
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Entity Type | Organization
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Legal Business Name | RED BIRD DENTAL, PLLC
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 08/03/2012
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Provider Practice Location Address
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Address Line | 8300 HOMESTEAD RD STE 3
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City | HOUSTON
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State | TX
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Zip | 77028-2149
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Country | US
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Telephone | 713-631-3700
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Fax | 713-631-3703
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Provider Business Mailing Address
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Address Line | 8300 HOMESTEAD RD STE 3
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City | HOUSTON
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State | TX
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Zip | 77028-2149
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Country | US
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Telephone | 713-631-3700
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Fax | 281-888-9571
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOON H KIM
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Credential | DDS
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Telephone | 713-631-3700
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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 | 22641
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License Number State | TX
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