Organization
J.B. GWAK, DDS, PLLC
Active
Other names
Snohomish Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JI WON GWAK DDS (DOCTOR/OWNER)
(310) 890-6457
Entity
Organization
Contact information
Practice address
306 MAPLE AVE, SNOHOMISH, WA 98290-2526
(310) 890-6457
(360) 568-4170
Mailing address
306 MAPLE AVE, SNOHOMISH, WA 98290-2526
(310) 890-6457
(360) 568-4170
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
604312870
UBI
WA
Enumeration date
11/26/2018
Last updated
11/26/2018
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