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General NPI Number Information
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NPI Number | 1053842716
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Entity Type | Individual
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Provider Name | ROSA G WU DMD
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Gender | Female
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 10/10/2018
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Provider Practice Location Address
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Address Line | 4403 CENTRAL AVE
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City | HOT SPRINGS
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State | AR
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Zip | 71913-7253
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Country | US
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Telephone | 501-270-7133
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Fax |
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Provider Business Mailing Address
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Address Line | 314 S UNIVERSITY AVE APT 1315
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5258
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Country | US
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Telephone | 407-965-6676
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4226
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License Number State | AR
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