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Organization
GP FAMILY DENTISTRY PLLC
Active
Organization
GP FAMILY DENTISTRY PLLC
Active
Other names
KREST DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
SOO BIN KIM DDS (OWNER/ DENTIST)
(404) 354-6787
Entity
Organization
Contact information
Practice address
117 N BELT LINE RD, GRAND PRAIRIE, TX 75050-5800
(972) 262-1395
(972) 262-1397
Mailing address
PO BOX 543248, GRAND PRAIRIE, TX 75054-3248
(972) 262-1395
(972) 262-1397
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21422
TX
Other
Enumeration date
12/06/2013
Last updated
12/06/2013
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