MEDICARE: CATHY KWONG DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN1860049	MA
2	122300000X	Dentist	DN25556	FL

General Provider Information

NPI Number	:	1568045805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHY KWONG DMD

Provider Business Mailing Address
First Line	:	3371 S ORANGE BLOSSOM TRL
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-6565
Country	:	US
Telephone Number	:	407-350-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3371 S ORANGE BLOSSOM TRL
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-6565
Country	:	US
Telephone Number	:	407-350-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2021
Last Update Date	:	11/21/2024

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Directions to “ CATHY KWONG DMD” Practice Location

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