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General NPI Number Information
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NPI Number | 1740689363
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Entity Type | Organization
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Legal Business Name | DR WU PEDIATRIC DENTISTRY, PLLC
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Dates
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Enumeration Date | 08/20/2014
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Last Update Date | 08/20/2014
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Provider Practice Location Address
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Address Line | 9750 BELLAIRE BLVD STE 250
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City | HOUSTON
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State | TX
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Zip | 77036-3446
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Country | US
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Telephone | 832-409-7168
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Fax | 832-777-7056
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Provider Business Mailing Address
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Address Line | 5511 BARON RIDGE LN
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City | KATY
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State | TX
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Zip | 77494-6613
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Country | US
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Telephone | 832-409-7168
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Fax | 832-777-7056
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUN WU
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Credential | D.D.S
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Telephone | 832-409-7168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 27077
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License Number State | TX
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