Healthcare Provider Details
I. General information
NPI: 1760386544
Provider Name (Legal Business Name): COCO DENTAL2, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
741 E DUNDEE RD
ARLINGTON HEIGHTS IL
60004-1542
US
IV. Provider business mailing address
741 E DUNDEE RD
ARLINGTON HEIGHTS IL
60004-1542
US
V. Phone/Fax
- Phone: 929-340-9390
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
YOOSUK
KO
Title or Position: PRESIDENT
Credential:
Phone: 929-340-9390