Provider Demographics
NPI:1801939418
Name:KUO, WAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:
Last Name:KUO
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 1:120 JACARANDA DR
Mailing Address - Street 2:#207
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2596
Mailing Address - Country:US
Mailing Address - Phone:702-354-8855
Mailing Address - Fax:
Practice Address - Street 1:5022 AIRPORT PULLING RD N
Practice Address - Street 2:UNIT #22
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-2407
Practice Address - Country:US
Practice Address - Phone:239-649-0598
Practice Address - Fax:239-649-7147
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL163781223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics