Individual
DR. THOMAS KWONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
5907 OAKLAND DR, PORTAGE, MI 49024-1120
(269) 327-4459
Mailing address
5907 OAKLAND DR, PORTAGE, MI 49024-1120
(269) 327-4459
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901020356
MI
1223G0001X
General Practice Dentistry
019027617
IL
Other
Enumeration date
06/06/2008
Last updated
11/02/2016
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