Komson Sudhivoraseth, D.D.S

NPI 1730406075 · on the registry since 2010 · sole proprietor

Practice

Address: 228 W Campbell Rd
Richardson, TX 75080
Phone: (972) 633-2377
Fax: (972) 633-2388
Organisation at this address: Synergy Dental, Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Licence states on file: TX
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2010-04-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas