RODERICK YOUNGDO KIM

FORT WORTH, TX
NPI1689954562
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy204E00000X Oral & Maxillofacial Surgery
(Licence: TX  32838)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
(Licence: TX  R2899)
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MI  2901020498)
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MI  4301108492)
Enumeration Date2011-08-23
Last Update Date2017-07-06
Business Address
-- RODERICK YOUNGDO KIM DDS, MD
1500 S MAIN ST DEPT OF
FORT WORTH, TX 76104-4917
Phone number: 817-702-6936
Mailing Address
-- RODERICK YOUNGDO KIM DDS, MD
1500 SOUTH MAIN DEPARTMENT OF OMFS
FORT WORTH, TX 76104
Phone number:
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