Individual
JASON KWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1024 PARK AVE, SUITE #1, PLAINFIELD, NJ 07060-3026
(908) 668-5888
Mailing address
1024 PARK AVE, SUITE #1, PLAINFIELD, NJ 07060-3026
(908) 668-5888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02563200
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0538558
—
NJ
Enumeration date
04/08/2013
Last updated
12/16/2016
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