Individual provider · Type 1 NPI

Tae Kwon

Orthodontics and Dentofacial Orthopedics Dentistry · Fresno, CA

NPI number 1992157572 Active

Practice location

1161 E Shepherd Ave Apt 201
Fresno, CA 93720-2046

Call (310) 890-0816 Map

Mailing address

777 Main St Unit 2404
Hartford, CT 06103-2325

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Orthodontics and Dentofacial Orthopedics Dentistry Primary 1223X0400X103782 (CA)

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

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About NPI 1992157572

Tae Kwon's National Provider Identifier is 1992157572, issued on Jul 7, 2016. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Fresno, CA. The record was last updated on Jul 16, 2019.