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Organization

BRIAN M. WOO, D.D.S., M.D., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN MICHAEL WOO D.D.S., M.D. (PRESIDENT/OWNER)
(559) 459-5120
Entity
Organization

Contact information

Practice address
290 NORTH WAYTE LANE, FRESNO, CA 93701-1324
(559) 459-5120
Mailing address
290 NORTH WAYTE LANE, FRESNO, CA 93701-1324
(559) 459-5120

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
50017
CA
1223P0106X
Oral and Maxillofacial Pathology Dentistry
50017
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
50017
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
A107428
CA
2086S0122X
Plastic and Reconstructive Surgery Physician
A107428
CA
2086S0127X
Trauma Surgery Physician
A107428
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50017
DENTAL LICENSE
CA
01
A107428
MEDICAL LICENSE
CA
01
GA 1484
GENERAL ANESTHESIA LICENSE
CA
Enumeration date
05/11/2009
Last updated
03/07/2023
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