| Diane Kim Dds Pllc | |
|
19725 Highway 59 N Humble TX 77338-3566 | |
| (281) 972-8000 | |
| Not Available |
| Full Name | Diane Kim Dds Pllc |
|---|---|
| Speciality | Dentist |
| Location | 19725 Highway 59 N, Humble, Texas |
| Authorized Official Name and Position | Diane Kim (OWNER) |
| Authorized Official Contact | 6463694078 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane Kim Dds Pllc 19725 Highway 59 N Humble TX 77338-3566 Ph: () - | Diane Kim Dds Pllc 19725 Highway 59 N Humble TX 77338-3566 Ph: (281) 972-8000 |
| NPI Number | 1023778768 |
|---|---|
| Provider Enumeration Date | 12/21/2021 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 8224416342 |
|---|---|
| Medicare Enrollment ID | O20220602000018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023778768 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Diane Jeong Kim |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1750939047 PECOS PAC ID: 9133507254 Enrollment ID: I20220602000032 |
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