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General NPI Number Information
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NPI Number | 1992969968
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Entity Type | Individual
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Provider Name | MARTIN MING-JEN FU B.D.S., B.S., D.M.SC
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Gender | Male
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 07/08/2015
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Provider Practice Location Address
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Address Line | 3779 S COOPER ST
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City | ARLINGTON
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State | TX
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Zip | 76015-3414
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Country | US
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Telephone | 442-777-3399
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Fax |
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Provider Business Mailing Address
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Address Line | 3409 CRESCENT CT
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City | PLANO
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State | TX
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Zip | 75093-7999
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Country | US
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Telephone | 442-777-3399
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 10135
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 29513
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License Number State | TX
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