Provider Demographics
NPI:1114074473
Name:KWOK, MABEL KAR LING (DDS)
Entity Type:Individual
Prefix:
First Name:MABEL
Middle Name:KAR LING
Last Name:KWOK
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 1:109 LAFAYETTE STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4138
Mailing Address - Country:US
Mailing Address - Phone:212-925-3857
Mailing Address - Fax:
Practice Address - Street 1:109 LAFAYETTE STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4138
Practice Address - Country:US
Practice Address - Phone:212-925-3857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0408971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics