Provider Demographics
NPI:1174721872
Name:WU, KUO-KUANG (DMD)
Entity type:Individual
Prefix:DR
First Name:KUO-KUANG
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:8180 BRECKSVILLE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1374
Mailing Address - Country:US
Mailing Address - Phone:440-526-8151
Mailing Address - Fax:440-792-4786
Practice Address - Street 1:8180 BRECKSVILLE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1374
Practice Address - Country:US
Practice Address - Phone:440-526-8151
Practice Address - Fax:440-792-4786
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2012-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300225281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice