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General NPI Number Information
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NPI Number | 1245712751
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Entity Type | Organization
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Legal Business Name | BENJAMIN J. KWOK, DDS, MS, LLC
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 1949A STATE ROUTE 37 W
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City | DELAWARE
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State | OH
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Zip | 43015-1052
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Country | US
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Telephone | 740-209-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 1949A STATE ROUTE 37 W
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City | DELAWARE
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State | OH
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Zip | 43015-1052
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Country | US
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Telephone | 740-209-2400
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. BENJAMIN KWOK
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Credential | DDS, MS
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Telephone | 614-949-7961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 30.024724
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License Number State | OH
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