Provider Demographics
NPI:1497284400
Name:KWIN DENTAL
Entity Type:Organization
Organization Name:KWIN DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:TRON
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:817-727-1129
Mailing Address - Street 1:9203 HIGHWAY 6 S STE 114
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-6387
Mailing Address - Country:US
Mailing Address - Phone:281-564-8100
Mailing Address - Fax:
Practice Address - Street 1:9203 HIGHWAY 6 S STE 114
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-6387
Practice Address - Country:US
Practice Address - Phone:281-564-8100
Practice Address - Fax:281-564-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental