Organization
ASHLEY FAMILY DENTAL, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOO H KWON DDS (OWNER)
(847) 244-0414
Entity
Organization
Contact information
Practice address
2504 WASHINGTON ST, STE #503, WAUKEGAN, IL 60085-4983
(847) 244-0414
(847) 244-3104
Mailing address
2504 WASHINGTON ST, STE #503, WAUKEGAN, IL 60085-4983
(847) 244-0414
(847) 244-3104
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182486
—
IL
Enumeration date
04/08/2008
Last updated
04/08/2008
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