Provider Demographics
NPI:1447494059
Name:HAN, WOO DANIEL (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:WOO DANIEL
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6850 BROCKTON AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3808
Mailing Address - Country:US
Mailing Address - Phone:951-686-5301
Mailing Address - Fax:951-686-3452
Practice Address - Street 1:6850 BROCKTON AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3808
Practice Address - Country:US
Practice Address - Phone:951-686-5301
Practice Address - Fax:951-686-3452
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549661223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics