Individual
KUONG C. KOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
483 W SEED FARM RD, SACATON, AZ 85147
(602) 528-1209
Mailing address
16337 W DURANGO ST, GOODYEAR, AZ 85338-2447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5765
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403913100
—
MN
Enumeration date
01/26/2006
Last updated
03/06/2012
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