Healthcare Provider Details

I. General information

NPI: 1396660072
Provider Name (Legal Business Name): CATHERINE KWON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHLOE KWON

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5979 35TH ST. AND DESERT STORM AVENUE KUHN DENTAL CLINIC
FORT CAMPBELL KY
42223
US

IV. Provider business mailing address

5979 35TH ST. AND DESERT STORM AVENUE
FORT CAMPBELL KY
42223
US

V. Phone/Fax

Practice location:
  • Phone: 888-217-4563
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14293804-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: