Healthcare Provider Details

I. General information

NPI: 1831578848
Provider Name (Legal Business Name): ROY H YOO DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9242 WALKER ST STE C
CYPRESS CA
90630-3169
US

IV. Provider business mailing address

9242 WALKER ST STE C
CYPRESS CA
90630-3169
US

V. Phone/Fax

Practice location:
  • Phone: 714-220-2003
  • Fax: 714-220-2004
Mailing address:
  • Phone: 714-220-2003
  • Fax: 714-220-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number53303
License Number StateCA

VIII. Authorized Official

Name: ROY YOO
Title or Position: OWNER
Credential: DMD
Phone: 714-220-2003