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General NPI Number Information
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NPI Number | 1134698020
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Entity Type | Organization
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Legal Business Name | WSYDDS
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Dates
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Enumeration Date | 11/20/2018
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 1851 W 84TH AVE
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City | FEDERAL HEIGHTS
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State | CO
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Zip | 80260-5044
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Country | US
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Telephone | 303-429-6411
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Fax |
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Provider Business Mailing Address
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Address Line | 2477 LAKE ISLE LN
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City | BROOMFIELD
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State | CO
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Zip | 80023-6534
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Country | US
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Telephone | 269-290-1418
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. WEI SUM YUEN
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Credential | DDS
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Telephone | 269-290-1418
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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 |
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License Number State |
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