Individual
ANNETTE KO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8525 CHEVY CHASE LAKE TER APT 554, CHEVY CHASE, MD 20815-4097
(949) 910-3750
Mailing address
30 N 23RD ST APT 902, PHILADELPHIA, PA 19103-1591
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS044064
PA
1223P0300X
Periodontics
Primary
18502
MD
1223P0300X
Periodontics
401419274
VA
1223P0300X
Periodontics
DEN2000428
DC
Other
Enumeration date
06/19/2023
Last updated
03/26/2025
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