| Organization Name: | KWON DENTAL CARE, P.C. |
| NPI Number: | 1124359575 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES IKJAE KWON (PRESIDENT) |
| Mailing Address: | 177 W Northwest Hwy Palatine |
| State: | IL US |
| Postal Code: | 600673550 |
| Phone Number: | 8479910903 |
| Fax Number: | 8479910832 |
| NPI Enumeration Date: | 01/26/2010 |
| NPI Last Update Date: | 04/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 019026324 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |