# WILLOWPLACE STAR DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710625470
- **Authorized official:** YOUNG SHIM DMD (MANAGER)
- **Authorized official phone:** (404) 512-0760

## Contact information

- **Practice address:** 17350 STATE HIGHWAY 249 STE 340, HOUSTON, TX 77064-1139
- **Practice address phone:** (832) 869-4185
- **Mailing address:** 17350 STATE HIGHWAY 249 STE 340, HOUSTON, TX 77064-1139
- **Mailing address phone:** (832) 869-4185

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | Yes |
| 1223D0001X | Public Health Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/23/2022
- **Last updated:** 06/13/2022