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NPI Code Detail

MEDICARE: DR. BILL KWOK SO D.D.S.

MEDICARE:  DR. BILL KWOK SO  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry20635TX

General Provider Information

NPI Number : 1790868594
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BILL KWOK SO D.D.S.
Provider Business Mailing Address
First Line : 9623 MARLIVE LN
Second Line :
City : HOUSTON
State : TX
Zip : 77025-4805
Country : US
Telephone Number : 713-498-2217
Fax Number :
Provider Business Practice Location Address
First Line : 4410 WESTWAY PARK BLVD STE 600
Second Line :
City : HOUSTON
State : TX
Zip : 77041-2039
Country : US
Telephone Number : 713-690-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 07/08/2007

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Directions to “ DR. BILL KWOK SO D.D.S.” Practice Location

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