# KWAK DENTAL MANAGEMENT, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417129974
- **Authorized official:** DR. HEE JOON KWAK (OWNER)
- **Authorized official phone:** (718) 991-8668

## Contact information

- **Practice address:** 638 EAST 169TH STREET, 2ND FLOOR, BRONX, NY 10456
- **Practice address phone:** (718) 991-8668
- **Mailing address:** 2321 144TH ST, 2ND FLOOR, WHITESTONE, NY 11357-3433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 051024-1 | NY | Yes |

## Other

- **Enumeration date:** 03/25/2008
- **Last updated:** 03/25/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02872984 | — | NY |
| 01 | — | 180681 | DORAL | NY |