Healthcare Provider Details

I. General information

NPI: 1972325512
Provider Name (Legal Business Name): TAEHYEOK WOO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 WASHINGTON ST STE 204
NORWELL MA
02061-1795
US

IV. Provider business mailing address

45 STUART ST APT 2513
BOSTON MA
02116-4781
US

V. Phone/Fax

Practice location:
  • Phone: 781-206-3077
  • Fax:
Mailing address:
  • Phone: 781-206-3077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10001532
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: