Organization
DESIGNED BY D
Active
Other names
Forest Dental Cafe
Organization subpart
No
Provider details
NPI number
Authorized official
DEMIAN JUNGMOOK KIM D.D.S (PRESIDENT)
(646) 306-5382
Entity
Organization
Contact information
Practice address
8075 FM 423 BLDG 3, SUITE 110, FRISCO, TX 75034
(646) 306-5382
Mailing address
4000 SIGMA RD, 9407, FARMERS BRANCH, TX 75244-8115
(646) 306-5382
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
27612
TX
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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