Organization
WAYLAND ORAL SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YONG-HAN KOO D.D.S. (PRESIDENT)
(203) 889-8916
Entity
Organization
Contact information
Practice address
241 BOSTON POST RD, SUITE 2, WAYLAND, MA 01778-1836
(203) 889-8916
Mailing address
241 BOSTON POST RD, SUITE 2, WAYLAND, MA 01778-1836
(203) 889-8916
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
DN22058
MA
Other
Enumeration date
04/19/2010
Last updated
04/19/2010
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