Provider Demographics
NPI:1477671659
Name:WOO, WILLIE (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIE
Middle Name:
Last Name:WOO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 WEBSTER ST STE 908
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3156
Mailing Address - Country:US
Mailing Address - Phone:510-653-7221
Mailing Address - Fax:510-653-6221
Practice Address - Street 1:3300 WEBSTER ST STE 908
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3156
Practice Address - Country:US
Practice Address - Phone:510-653-7221
Practice Address - Fax:510-653-6221
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice