Provider Demographics
NPI:1649572686
Name:SSK DENTAL PLLC
Entity Type:Organization
Organization Name:SSK DENTAL PLLC
Other - Org Name:DENTURE WORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:SEJOON
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-443-7777
Mailing Address - Street 1:132 FM 1960 E.
Mailing Address - Street 2:B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-1814
Mailing Address - Country:US
Mailing Address - Phone:281-443-7777
Mailing Address - Fax:281-443-3397
Practice Address - Street 1:132 FM 1960 E.
Practice Address - Street 2:B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-1814
Practice Address - Country:US
Practice Address - Phone:281-443-7777
Practice Address - Fax:281-443-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty