Organization
J & KWAK COMPANY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TJ LEE (OFFICE MANAGER)
(347) 634-0224
Entity
Organization
Contact information
Practice address
1790 RANDALL AVE, BRONX, NY 10473-3629
(347) 634-0224
(718) 991-2662
Mailing address
1790 RANDALL AVE, BRONX, NY 10473-3629
(347) 634-0224
(718) 991-2662
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
051024
NY
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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