Provider Demographics
NPI:1073645776
Name:WOO, SHUN-WAH CECILIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHUN-WAH
Middle Name:CECILIA
Last Name:WOO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CECILIA
Other - Middle Name:
Other - Last Name:WOO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:8320 CROYDON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3037
Mailing Address - Country:US
Mailing Address - Phone:310-568-8304
Mailing Address - Fax:
Practice Address - Street 1:8320 CROYDON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3037
Practice Address - Country:US
Practice Address - Phone:310-568-8304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27499122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist