Jessica Kwon
Dentist, Pediatric Dentistry in San Jacinto, CA. Individual provider (NPI-1).
NPI number1043731433
StatusActive
Last updated in NPPESJun 8, 2022
Details
- NPI
- 1043731433
- Entity type
- Individual (NPI-1)
- Name
- Jessica Kwon
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 6, 2017
- Certification date
- Jun 8, 2022
- Last updated
- Jun 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | 101510 | CA | Yes |
Practice location
1643 S San Jacinto Ave Ste ASan Jacinto, CA 92583-5181
Phone 951-654-7744
Mailing address
421 S Ash StRedlands, CA 92373-5859
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