| Organization Name: | KAREN KOO DDS DENTAL CORP. |
| NPI Number: | 1083056204 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAREN KOO (PRESIDENT) |
| Mailing Address: | 936 E Imperial Hwy Brea |
| State: | CA US |
| Postal Code: | 928215612 |
| Phone Number: | 7149904911 |
| Fax Number: | 7149905883 |
| NPI Enumeration Date: | 07/30/2013 |
| NPI Last Update Date: | 07/30/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 52071 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |