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General NPI Number Information
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NPI Number | 1942454723
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Entity Type | Organization
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Legal Business Name | SPRING SMILE INC
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 11/06/2008
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Provider Practice Location Address
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Address Line | 5812 PATHFINDER TRL
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City | PLANO
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State | TX
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Zip | 75093-4517
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Country | US
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Telephone | 214-207-7639
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Fax |
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Provider Business Mailing Address
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Address Line | 3535 N BUCKNER BLVD SUITE 114
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City | DALLAS
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State | TX
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Zip | 75228-5548
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Country | US
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Telephone | 214-321-7777
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | DR. TAEHEE KIM
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Credential | DDS
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Telephone | 214-207-7639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 23243
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License Number State | TX
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