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General NPI Number Information
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NPI Number | 1093936718
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Entity Type | Organization
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Legal Business Name | LUP CHUNG SUEN, D.M.D., INC.
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 1215 PLUMAS ST SUITE # 52
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City | YUBA CITY
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State | CA
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Zip | 95991-3455
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Country | US
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Telephone | 530-755-9968
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Fax | 530-755-4557
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Provider Business Mailing Address
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Address Line | 1215 PLUMAS ST SUITE # 52
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City | YUBA CITY
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State | CA
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Zip | 95991-3455
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Country | US
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Telephone | 530-755-9968
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Fax | 530-755-4557
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Authorized Official
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Title or Position | SECRETARY
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Name | MS. LUCY L. SUEN
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Credential |
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Telephone | 530-755-9968
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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 | 39505
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License Number State | CA
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