Provider Demographics
NPI:1295988707
Name:KWON, PAUL YOO (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:YOO
Last Name:KWON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 F ST SW
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:WA
Mailing Address - Zip Code:98848-1370
Mailing Address - Country:US
Mailing Address - Phone:509-787-1507
Mailing Address - Fax:509-787-2100
Practice Address - Street 1:746 F ST SW
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:WA
Practice Address - Zip Code:98848-1370
Practice Address - Country:US
Practice Address - Phone:509-787-1507
Practice Address - Fax:509-787-2100
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE600235381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE60023538OtherWASHINGTON STATE DENTAL LICENSE