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General NPI Number Information
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NPI Number | 1992656946
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Entity Type | Organization
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Legal Business Name | S. KWONG DDS, A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 1805 NOVATO BLVD STE 4
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City | NOVATO
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State | CA
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Zip | 94947-2934
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Country | US
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Telephone | 415-898-0696
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Fax |
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Provider Business Mailing Address
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Address Line | 1805 NOVATO BLVD STE 4
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City | NOVATO
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State | CA
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Zip | 94947-2934
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | SARA KWONG
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Credential |
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Telephone | 415-898-0696
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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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