Organization
SAMUEL S KWON - LOGANVILLE DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL S KWON DMD (OWNER)
(678) 714-7575
Entity
Organization
Contact information
Practice address
2101 BAKER CARTER DRIVE, SUITE 200, LOGANVILLE, GA 30052
(678) 714-7575
(678) 714-7525
Mailing address
3590 BRASELTON HWY, SUITE 201, DACULA, GA 30019-1117
(678) 714-7575
(678) 714-7525
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN012687
GA
Other
Enumeration date
12/07/2015
Last updated
12/07/2015
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