Organization
ANNABEL S. KOA , DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUVITH BING PALADO-VELASCO (DENTAL BILLER)
(650) 484-8851
Entity
Organization
Contact information
Practice address
400 N SAN MATEO DR STE 2, SAN MATEO, CA 94401-2418
(650) 484-8851
Mailing address
6419 BRANDO LOOP, FAIR OAKS, CA 95628-3764
(650) 278-6055
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52877
DENTAL LICENSE
CA
Enumeration date
05/29/2020
Last updated
05/29/2020
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