Provider Demographics
NPI:1003902032
Name:KWON, KEE-WON (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEE-WON
Middle Name:
Last Name:KWON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 COIT RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3773
Mailing Address - Country:US
Mailing Address - Phone:262-349-7509
Mailing Address - Fax:
Practice Address - Street 1:2301 COIT RD
Practice Address - Street 2:SUITE A
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3773
Practice Address - Country:US
Practice Address - Phone:262-349-7509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI56361223P0221X
TX286941223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry