Individual
TAEKEONG KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3411 SYCAMORE SCHOOL RD, FORT WORTH, TX 76123-2091
(682) 233-9326
Mailing address
5270 N O CONNOR BLVD APT 1524, IRVING, TX 75039-5725
(415) 996-4082
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
38362
TX
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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