MEDICARE: YOO CARE DENTAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1780217141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOO CARE DENTAL PLLC

Provider Business Mailing Address
First Line	:	17322 LEGEND BROOK CT
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77375-1065
Country	:	US
Telephone Number	:	512-608-7077
Fax Number	:

Provider Business Practice Location Address
First Line	:	23015 FM 529 SUITE 400
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-7749
Country	:	US
Telephone Number	:	832-786-1146
Fax Number	:

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	CLARA J YOO
Credential	:	DDS
Telephone Number	:	512-608-7077

Provider Enumeration Date	:	02/13/2020
Last Update Date	:	02/22/2020

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