Provider Demographics
NPI:1730276940
Name:WUITENG KOH, DDS, MS, PS
Entity type:Organization
Organization Name:WUITENG KOH, DDS, MS, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WUITENG
Authorized Official - Middle Name:
Authorized Official - Last Name:KOH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:206-365-3666
Mailing Address - Street 1:11050 5TH AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6151
Mailing Address - Country:US
Mailing Address - Phone:206-365-3666
Mailing Address - Fax:206-440-3298
Practice Address - Street 1:11050 5TH AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6151
Practice Address - Country:US
Practice Address - Phone:206-365-3666
Practice Address - Fax:206-440-3298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2011-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA69441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty