Individual
KIM THI VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3811 W HIGHWAY 31 STE 108, CORSICANA, TX 75110-9211
(903) 229-4573
Mailing address
4712 SEA HAWK ST, GRAND PRAIRIE, TX 75052-4147
(469) 882-8883
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
23133
TX
Other
Enumeration date
07/19/2006
Last updated
08/13/2024
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