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General NPI Number Information
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NPI Number | 1144995705
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Entity Type | Organization
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Legal Business Name | WINNIE TU DDS INC
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Dates
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Enumeration Date | 08/14/2021
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Last Update Date | 08/14/2021
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Provider Practice Location Address
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Address Line | 3975 JACKSON ST STE 306
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City | RIVERSIDE
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State | CA
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Zip | 92503-3951
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Country | US
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Telephone | 951-343-1211
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Fax | 951-343-1481
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Provider Business Mailing Address
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Address Line | 3975 JACKSON ST STE 306
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City | RIVERSIDE
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State | CA
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Zip | 92503-3951
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Country | US
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Telephone | 951-743-0258
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. WEIMIN TU
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Credential | DENTIST
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Telephone | 951-743-0258
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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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