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Organization
SPA DENTAL
Active
Organization
SPA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN M KOO DDS (DENTIST)
(972) 530-7374
Entity
Organization
Contact information
Practice address
5435 NORTH GARLAND AVE 125, GARLAND, TX 75034
(972) 530-7374
(972) 530-7636
Mailing address
5435 NORTH GARLAND AVE 125, GARLAND, TX 75034
(972) 530-7374
(972) 530-7636
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16975
TX
Other
Enumeration date
11/22/2006
Last updated
08/22/2020
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