Organization
HIEM DENTAL CORP
Active
Other names
Wellness Dental Tatum/Shea
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONGSUK KWAK (AUTHORIZED OFFICIAL)
(602) 899-0488
Entity
Organization
Contact information
Practice address
10214 N TATUM BLVD, B600, PHOENIX, AZ 85028-4231
(602) 899-0488
Mailing address
10214 N TATUM BLVD, B600, PHOENIX, AZ 85028-4231
(602) 899-0488
(602) 884-8240
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
F000542
AZ
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
02/09/2015
Last updated
11/14/2022
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