Organization
LONE STAR DENTAL ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JINSOO KIM DDS (OWNER)
(972) 536-3972
Entity
Organization
Contact information
Practice address
4112 E RENNER RD, RICHARDSON, TX 75082-2832
(972) 536-3972
Mailing address
4112 E RENNER RD, RICHARDSON, TX 75082-2832
(972) 536-3972
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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