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General NPI Number Information
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NPI Number | 1215998562
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Entity Type | Organization
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Legal Business Name | YVONNE KWONG DMD PA
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 04/29/2013
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Provider Practice Location Address
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Address Line | 120 SISTER PIERRE DRIVE #502
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City | TOWSON
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State | MD
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Zip | 21204
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Country | US
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Telephone | 410-321-8144
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Fax | 410-296-2790
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Provider Business Mailing Address
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Address Line | 120 SISTER PIERRE DRIVE #502
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City | TOWSON
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State | MD
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Zip | 21204
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Country | US
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Telephone | 410-321-8144
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Fax | 410-296-2790
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. YVONNE YUEN KWONG
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Credential | DMD
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Telephone | 410-321-8144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 12108
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License Number State | MD
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