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General NPI Number Information
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NPI Number | 1376728980
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Entity Type | Individual
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Provider Name | ZONGYANG SUN DDS, MS, MSD, PHD
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Gender | Male
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 305 W 12TH AVE 4088C POSTLE HALL
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City | COLUMBUS
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State | OH
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Zip | 43210-1267
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Country | US
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Telephone | 614-247-7944
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Fax | 614-688-3077
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Provider Business Mailing Address
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Address Line | 305 W 12TH AVE 4088C POSTLE HALL
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City | COLUMBUS
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State | OH
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Zip | 43210-1267
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Country | US
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Telephone | 614-247-7944
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Fax | 614-688-3077
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 71.000210
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License Number State | OH
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