Provider Demographics
NPI:1982704573
Name:KOO, CATHERINE LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LEE
Last Name:KOO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4944 PRESTON RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8597
Mailing Address - Country:US
Mailing Address - Phone:972-731-5680
Mailing Address - Fax:972-731-5604
Practice Address - Street 1:4944 PRESTON RD
Practice Address - Street 2:SUITE 108
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-8597
Practice Address - Country:US
Practice Address - Phone:972-731-5680
Practice Address - Fax:972-731-5604
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice