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General NPI Number Information
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NPI Number | 1609266162
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Entity Type | Organization
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Legal Business Name | ALVIN K LOO DDS A DENTAL CORP
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 50949 WASHINGTON ST UNIT G
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City | LA QUINTA
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State | CA
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Zip | 92253-2890
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Country | US
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Telephone | 760-564-0350
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Fax | 760-564-0736
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Provider Business Mailing Address
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Address Line | 50949 WASHINGTON ST UNIT G
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City | LA QUINTA
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State | CA
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Zip | 92253-2890
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Country | US
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Telephone | 760-564-0350
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Fax | 760-564-0736
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Authorized Official
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Title or Position | OWNER
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Name | DR. KWOR LOO
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Credential | DDS
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Telephone | 760-564-0350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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