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Roderick Youngdo Kim, DDS,MD
Student in an Organized Health Care Education/Training Program in Fort Worth, Texas
NPI 1689954562

Roderick Youngdo Kim is a Student in an Organized Health Care Education/Training Program based in Fort Worth, TX. Roderick Youngdo Kim practices in Fort Worth, TX and has the professional credentials of DDS,MD. The NPI Number for Roderick Youngdo Kim is 1689954562 and holds a License No. R2899 (Texas).

The current practice location address for Roderick Youngdo Kim is 1500 S Main St Dept Of, Fort Worth, TX and can be reached out via phone at 817-702-6936. You can also correspond with Roderick Youngdo Kim through the mailing address at 1500 SOUTH MAIN, FORT WORTH, TX - 76104 (mailing address contact number: ).

Location: 1500 S Main St Dept Of, Fort Worth, TX, 76104
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1689954562
Provider Name
Roderick Youngdo Kim
Credential
DDS,MD
Provider Entity Type
Individual
Gender
Male
Address
1500 S Main St Dept Of, Fort Worth, TX, 76104
Phone Number
817-702-6936
Fax Number
Provider Enumeration Date
08/23/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1500 S Main St Dept Of
City
Fort Worth
State
Texas
Zip
76104-4917
Phone Number
817-702-6936
Fax Number
person
Provider Business Mailing Address Details
Address
1500 S Main St Dept Of
City
Fort Worth
State
Texas
Zip
76104-4917
Phone Number
817-702-6936
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Oral & Maxillofacial Surgery
Speciality
-
Taxonomy
204E00000X
License No.
32838 (Texas)
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
R2899 (Texas)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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