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Organization

BOUYEAN DENTISTRY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NICKOLAS KIM DDS (DENTIST)
(702) 505-1257
Entity
Organization

Contact information

Practice address
1108 W DICKINSON BLVD STE B, FORT STOCKTON, TX 79735-4201
(432) 336-8700
Mailing address
1108 W DICKINSON BLVD STE B, FORT STOCKTON, TX 79735-4201
(432) 336-8700

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
10/03/2022
Last updated
10/03/2022
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