Provider Demographics
NPI:1528109204
Name:BALDWIN J. HOO, D.D.S. A PROFESSIONAL DENTAL CORP.
Entity type:Organization
Organization Name:BALDWIN J. HOO, D.D.S. A PROFESSIONAL DENTAL CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BALDWIN
Authorized Official - Middle Name:JIN
Authorized Official - Last Name:HOO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-873-8888
Mailing Address - Street 1:1150 EL CAMINO REAL
Mailing Address - Street 2:SUITE 128
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066
Mailing Address - Country:US
Mailing Address - Phone:650-873-8888
Mailing Address - Fax:650-873-8787
Practice Address - Street 1:1150 EL CAMINO REAL
Practice Address - Street 2:SUITE 128
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066
Practice Address - Country:US
Practice Address - Phone:650-873-8888
Practice Address - Fax:650-873-8787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty