Sam S Kwon
Pediatric Dentist
3635 Braselton Hwy Suite C
Dacula
, Georgia 30019-1068
Sam S Kwon
Pediatric Dentist
3635 Braselton Hwy Suite C
Dacula
, Georgia 30019-1068
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About
Features
Specialties
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Sam S Kwon
- 4731 Cambridge Trce
- Atlanta, GA
- Zip : 30338-5252
- Phone :
Second Address
- Sam S Kwon
- 3635 Braselton Hwy Suite C
- Dacula, GA
- Zip : 30019-1068
- Fax : (678) 714-7525
- Phone : (678) 714-7575
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0221X | Pediatric Dentist | DN012637 | GA |
National Provider Identifier
| NPI | 1013054402 |
|---|---|
| Provider Name | Sam S Kwon |
| First Address | Atlanta, GA 30338-5252 |
| Second Address | Dacula, GA 30019-1068 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/02/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.