Provider Demographics
NPI:1194029546
Name:KWAK, SUNGHEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUNGHEE
Middle Name:
Last Name:KWAK
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 1:7 SYLVAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2413
Mailing Address - Country:US
Mailing Address - Phone:201-302-0700
Mailing Address - Fax:201-302-9857
Practice Address - Street 1:7 SYLVAN AVENUE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:PR
Practice Address - Zip Code:07632-2413
Practice Address - Country:US
Practice Address - Phone:201-302-0700
Practice Address - Fax:201-302-9857
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020640001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry