Provider Demographics
NPI:1225150022
Name:KWOK, JASON (DMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:KWOK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 WYNGATE CT
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-5650
Mailing Address - Country:US
Mailing Address - Phone:727-542-6281
Mailing Address - Fax:
Practice Address - Street 1:907 WYNGATE CT
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-5650
Practice Address - Country:US
Practice Address - Phone:727-542-6281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 14092122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist