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General NPI Number Information
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NPI Number | 1457790784
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Entity Type | Individual
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Provider Name | JULIA KOO DDS
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Gender | Female
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 04/07/2018
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Provider Practice Location Address
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Address Line | 29 EMMONS DR STE C80
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City | PRINCETON
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State | NJ
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Zip | 08540-5983
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Country | US
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Telephone | 609-514-1666
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Fax |
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Provider Business Mailing Address
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Address Line | 220 E COLUMBIA AVE UNIT B
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City | PALISADES PARK
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State | NJ
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Zip | 07650-1902
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Country | US
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Telephone | 201-988-9833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 02554500
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License Number State | NJ
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