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General NPI Number Information
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NPI Number | 1013172824
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Entity Type | Organization
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Legal Business Name | HOLLY WU, DDS, INC.
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 04/01/2013
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Provider Practice Location Address
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Address Line | 3220 SEPULVEDA BLVD #206
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City | TORRANCE
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State | CA
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Zip | 90505-2744
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Country | US
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Telephone | 310-325-5877
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Fax |
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Provider Business Mailing Address
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Address Line | 3220 SEPULVEDA BLVD #206
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City | TORRANCE
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State | CA
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Zip | 90505-2744
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Country | US
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Telephone | 310-325-5877
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HOLLY WU
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Credential | DDS
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Telephone | 310-325-5877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 39354
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License Number State | CA
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