Provider Demographics
NPI:1699229294
Name:ROO, KUNHO (DDS)
Entity Type:Individual
Prefix:DR
First Name:KUNHO
Middle Name:
Last Name:ROO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SPARTA RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1424
Mailing Address - Country:US
Mailing Address - Phone:254-939-7800
Mailing Address - Fax:
Practice Address - Street 1:201 SPARTA RD STE 201
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1424
Practice Address - Country:US
Practice Address - Phone:254-939-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019030885122300000X
TX34803122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist