Individual
JENNY KWON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2537 W NORTH AVE, MELROSE PARK, IL 60160-1121
(708) 345-6400
Mailing address
512 N MCCLURG CT, UNIT 4106, CHICAGO, IL 60611-5359
(312) 955-0204
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019028247
IL
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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