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General NPI Number Information
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NPI Number | 1831874650
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Entity Type | Organization
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Legal Business Name | K2 MICHIGAN ORTHODONTICS PLLC
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 214 W MICHIGAN AVE
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City | SALINE
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State | MI
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Zip | 48176-1327
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Country | US
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Telephone | 734-395-1214
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 CORNWELL DR
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City | ANN ARBOR
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State | MI
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Zip | 48105-2978
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Country | US
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Telephone | 734-395-1214
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWIN KWON
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Credential | DDS
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Telephone | 734-395-1214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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