| Mary Kim, DMD | |
|
2828 International Cir Ste 100, Colorado Springs, CO 80910-3127 | |
| (719) 344-6565 | |
| (719) 344-7819 |
| Full Name | Mary Kim |
|---|---|
| Gender | Female |
| Speciality | Dentist |
| Location | 2828 International Cir Ste 100, Colorado Springs, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184165516 | NPI | - | NPPES |
| Entity Name | Southside Medical Center, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235123993 PECOS PAC ID: 6901700723 Enrollment ID: O20031212000357 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Kim, DMD 3205 N Academy Blvd Ste 130, Colorado Springs, CO 80917-5152 Ph: (719) 344-6575 | Mary Kim, DMD 2828 International Cir Ste 100, Colorado Springs, CO 80910-3127 Ph: (719) 344-6565 |
Dr. Alan David Walker, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2110 Southgate Rd, Colorado Springs, CO 80906 Phone: 719-635-5705 |
Dr. Paul J. Lombardi, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2828 International Cir, Suite 100, Colorado Springs, CO 80910 Phone: 719-632-5700 |
Dr. Yasufumi Yamazaki, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2436 S Academy Blvd, Colorado Springs, CO 80916 Phone: 719-331-2336 Fax: 719-391-1625 |
Tetyana Korchynskyy, DMD, MSD Dentist Medicare: Medicare Enrolled Practice Location: 1694 E Cheyenne Mountain Blvd, Colorado Springs, CO 80906 Phone: 719-538-4671 |
Dwayne Preston Hall, DDS Dentist Medicare: Medicare Enrolled Practice Location: 5944 Stetson Hills Blvd, Ste 100, Colorado Springs, CO 80922 Phone: 719-638-2260 Fax: 719-638-2261 |
Dr. Abraham Kanjappallil Thomas, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 5426 N Academy Blvd, Ste 202, Colorado Springs, CO 80918 Phone: 719-266-5420 Fax: 719-266-6988 |
Dr. Derek Allan Miller, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 6160 Tutt Blvd, Suite 140, Colorado Springs, CO 80923 Phone: 719-550-1010 Fax: 719-550-1212 |