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General NPI Number Information
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NPI Number | 1922448778
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Entity Type | Organization
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Legal Business Name | GILSUN YU DDS PLLC
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 4017 A ST SE STE 104
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City | AUBURN
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State | WA
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Zip | 98002-8607
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Country | US
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Telephone | 253-737-5188
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Fax | 253-249-7747
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Provider Business Mailing Address
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Address Line | PO BOX 520
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City | BELLEVUE
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State | WA
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Zip | 98009-0520
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Country | US
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Telephone | 253-737-5188
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Fax | 253-249-7747
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | GILSUN YU
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Credential | DDS
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Telephone | 253-737-5188
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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 | DE00010059
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License Number State | WA
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