Provider Demographics
NPI:1750446472
Name:ROBERT C.S. WOO, D.D.S., P.S.
Entity Type:Organization
Organization Name:ROBERT C.S. WOO, D.D.S., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C S
Authorized Official - Last Name:WOO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-833-9524
Mailing Address - Street 1:1340 8TH ST NE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4700
Mailing Address - Country:US
Mailing Address - Phone:253-833-9524
Mailing Address - Fax:253-833-8316
Practice Address - Street 1:1340 8TH ST NE
Practice Address - Street 2:SUITE 101
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4700
Practice Address - Country:US
Practice Address - Phone:253-833-9524
Practice Address - Fax:253-833-8316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000049981223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT01911Medicare UPIN