Organization
SAMUEL S KWON - ATHENS DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA MAGUIRE (CREDENTIALING COORDINATOR)
(678) 714-7575
Entity
Organization
Contact information
Practice address
1795 RESURGENCE DRIVE, SUITE 101, WATKINSVILLE, GA 30677
(678) 714-7575
(678) 804-9434
Mailing address
1795 RESURGENCE DRIVE, SUITE 101, WATKINSVILLE, GA 30677
(678) 714-7575
(678) 804-9434
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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