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NPI 1891909735

NPI 1891909735 : HUNG LU D.D.S. : FRESNO, CA

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General NPI Number Information
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    NPI Number           |    1891909735
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    Entity Type          |    Individual 
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    Provider Name        |    HUNG LU D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/10/2007
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    Last Update Date     |    07/12/2018
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Provider Practice Location Address
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    Address Line         |    4686 N 1ST ST 
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    City                 |    FRESNO
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    State                |    CA
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    Zip                  |    93726
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    Country              |    US
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    Telephone            |    559-225-8337
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    Fax                  |    559-225-8331
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Provider Business Mailing Address
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    Address Line         |    4686 N 1ST ST 
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    City                 |    FRESNO
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    State                |    CA
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    Zip                  |    93726-0903
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    Country              |    US
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    Telephone            |    559-225-8337
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    Fax                  |    559-225-8331
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    44734
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    License Number State |    CA
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