Provider Demographics
NPI:1609483239
Name:BAPTISTA KWOK DDS1 PLLC
Entity type:Organization
Organization Name:BAPTISTA KWOK DDS1 PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BAPTISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:KWOK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-639-6868
Mailing Address - Street 1:17265 SE WAX RD.
Mailing Address - Street 2:#101
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042
Mailing Address - Country:US
Mailing Address - Phone:253-639-6868
Mailing Address - Fax:253-639-7818
Practice Address - Street 1:17265 SE WAX RD.
Practice Address - Street 2:#101
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042
Practice Address - Country:US
Practice Address - Phone:253-639-6868
Practice Address - Fax:253-639-7818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty