| Kwak Dental Management, Pllc | |
|
638 East 169th Street 2nd Floor Bronx NY 10456 | |
| (718) 991-8668 | |
| Not Available |
| Full Name | Kwak Dental Management, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 638 East 169th Street, Bronx, New York |
| Authorized Official Name and Position | Hee Joon Kwak (OWNER) |
| Authorized Official Contact | 7189918668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kwak Dental Management, Pllc 2321 144th St 2nd Floor Whitestone NY 11357-3433 Ph: () - | Kwak Dental Management, Pllc 638 East 169th Street 2nd Floor Bronx NY 10456 Ph: (718) 991-8668 |
| NPI Number | 1417129974 |
|---|---|
| Provider Enumeration Date | 03/25/2008 |
| Last Update Date | 03/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417129974 | NPI | - | NPPES |
| 180681 | Other | NY | DORAL |
| 02872984 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 051024-1 (New York) | Primary |
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