Individual
KENNIE KWOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4060 4TH AVE, SUITE 303, SAN DIEGO, CA 92103-2116
(619) 543-0905
Mailing address
4060 4TH AVE, SUITE 303, SAN DIEGO, CA 92103-2116
(619) 543-0905
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
65162
CA
Other
Enumeration date
06/14/2012
Last updated
07/14/2016
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