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General NPI Number Information
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NPI Number | 1457806788
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Entity Type | Organization
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Legal Business Name | 4UDENTAL GROUP PARTNERS
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Dates
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Enumeration Date | 08/16/2016
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 9636 GARDEN GROVE BLVD STE 3
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City | GARDEN GROVE
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State | CA
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Zip | 92844-1590
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Country | US
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Telephone | 714-590-2828
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Fax | 714-590-2846
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Provider Business Mailing Address
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Address Line | 9636 GARDEN GROVE BLVD STE 3
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City | GARDEN GROVE
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State | CA
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Zip | 92844-1590
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Country | US
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Telephone | 714-590-2828
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Fax | 714-590-2846
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | MR. KOO OH
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Credential | D.D.S.
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Telephone | 714-590-2828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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