Organization
1010 EMERGENCY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAKE KIM DDS (OWNER)
(703) 477-4659
Entity
Organization
Contact information
Practice address
507 JEFFERSON LN, LAKE DALLAS, TX 75065-3489
(703) 477-4659
Mailing address
507 JEFFERSON LN, LAKE DALLAS, TX 75065-3489
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/13/2024
Last updated
11/24/2024
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