Provider Demographics
NPI:1073166823
Name:LOO, CHRISTIAN ALEXANDER (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:ALEXANDER
Last Name:LOO
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24600 DETROIT RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2542
Mailing Address - Country:US
Mailing Address - Phone:440-808-9809
Mailing Address - Fax:440-808-9984
Practice Address - Street 1:24600 DETROIT RD STE 200
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2542
Practice Address - Country:US
Practice Address - Phone:440-808-9809
Practice Address - Fax:440-808-9984
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0273101223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics