Individual
JAE H. KWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1631 EDINGER AVE STE 105, TUSTIN, CA 92780-6537
(714) 717-3757
Mailing address
24635 MADISON AVE, MURRIETA, CA 92562-9751
(469) 449-3162
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
32379
TX
1223P0221X
Pediatric Dentistry
Primary
102524
CA
Other
Enumeration date
09/28/2016
Last updated
03/02/2023
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