Provider Demographics
NPI:1760098180
Name:BAPTISTAKWOKDDS1,PLLC
Entity Type:Organization
Organization Name:BAPTISTAKWOKDDS1,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAPTISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:KWOK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-818-6386
Mailing Address - Street 1:17265 SE WAX RD STE 101
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-9102
Mailing Address - Country:US
Mailing Address - Phone:253-639-6868
Mailing Address - Fax:253-639-7818
Practice Address - Street 1:17265 SE WAX RD STE 101
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-9102
Practice Address - Country:US
Practice Address - Phone:253-639-6868
Practice Address - Fax:253-639-7818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental