| J & Kwak Company, Llc | |
|
1790 Randall Ave Bronx NY 10473-3629 | |
| (347) 634-0224 | |
| (718) 991-2662 |
| Full Name | J & Kwak Company, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1790 Randall Ave, Bronx, New York |
| Authorized Official Name and Position | Tj Lee (OFFICE MANAGER) |
| Authorized Official Contact | 3476340224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J & Kwak Company, Llc 1790 Randall Ave Bronx NY 10473-3629 Ph: (347) 634-0224 | J & Kwak Company, Llc 1790 Randall Ave Bronx NY 10473-3629 Ph: (347) 634-0224 |
| NPI Number | 1740690445 |
|---|---|
| Provider Enumeration Date | 05/02/2014 |
| Last Update Date | 05/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740690445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 051024 (New York) | Primary |
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