Provider Demographics
NPI:1699906586
Name:KATSUKO MATSUI INC. A PROFESSIONAL DENTAL COOPERATION
Entity type:Organization
Organization Name:KATSUKO MATSUI INC. A PROFESSIONAL DENTAL COOPERATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KATSUKO
Authorized Official - Middle Name:
Authorized Official - Last Name:MATSUI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-995-2040
Mailing Address - Street 1:5631 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3156
Mailing Address - Country:US
Mailing Address - Phone:714-995-2040
Mailing Address - Fax:714-995-2081
Practice Address - Street 1:5631 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-3156
Practice Address - Country:US
Practice Address - Phone:714-995-2040
Practice Address - Fax:714-995-2081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44339261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental