Healthcare Provider Details

I. General information

NPI: 1437173317
Provider Name (Legal Business Name): XUEWEN S CUI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 S CLOVIS AVE STE 107
FRESNO CA
93727-4284
US

IV. Provider business mailing address

132 W GOSHEN AVE
CLOVIS CA
93611-7197
US

V. Phone/Fax

Practice location:
  • Phone: 559-255-3333
  • Fax: 559-255-7271
Mailing address:
  • Phone: 559-325-9575
  • Fax: 558-255-7271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number45446
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: