Healthcare Provider Details

I. General information

NPI: 1730250895
Provider Name (Legal Business Name): STEPHEN S HSU D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SHYH-LIH HSU D.M.D.

II. Dates (important events)

Enumeration Date: 11/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 STILES RD SUITE 207
SALEM NH
03079-2892
US

IV. Provider business mailing address

32 STILES RD SUITE 207
SALEM NH
03079-2892
US

V. Phone/Fax

Practice location:
  • Phone: 603-898-8611
  • Fax:
Mailing address:
  • Phone: 603-898-8611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2377
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: