Provider Demographics
NPI:1043668007
Name:NORTH HOUSTON ORAL SURGERY GROUP,PLLC
Entity Type:Organization
Organization Name:NORTH HOUSTON ORAL SURGERY GROUP,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEJOON
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-821-3333
Mailing Address - Street 1:152 FM 1960 RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-1815
Mailing Address - Country:US
Mailing Address - Phone:281-821-3333
Mailing Address - Fax:281-443-3397
Practice Address - Street 1:152 FM 1960 RD
Practice Address - Street 2:SUITE D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-1815
Practice Address - Country:US
Practice Address - Phone:281-821-3333
Practice Address - Fax:281-443-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty