Individual
DR. JASON WESLEY KWOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
130 NEW LONDON TPKE STE 4, NORWICH, CT 06360-2624
(860) 889-1660
Mailing address
130 NEW LONDON TPKE STE 4, NORWICH, CT 06360-2624
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
101603
CA
1223E0200X
Endodontics
Primary
12678
CT
1223G0001X
General Practice Dentistry
DDS101603
CA
Other
Enumeration date
02/19/2016
Last updated
11/05/2020
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