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Organization
KWON DDS PROFESSIONAL CORPORATION
Active
Organization
KWON DDS PROFESSIONAL CORPORATION
Active
Parent organization
KWON DDS PROFESSIONAL CORPORATION
Other names
Mead Valley Community Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
KWON DDS PROFESSIONAL CORPORATION
Authorized official
DR. OH JAE KWON DDS (PRESIDENT)
(951) 322-4058
Entity
Organization
Contact information
Practice address
21091 RIDER ST, SUITE 203, PERRIS, CA 92570-8878
(951) 322-4058
Mailing address
21091 RIDER ST, SUITE 203, PERRIS, CA 92570-8878
(951) 322-4058
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
46484
CA
Other
Enumeration date
09/27/2013
Last updated
02/10/2017
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