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NPI Code Detail

MEDICARE: YUN KEUNG TSE D.D.S.

MEDICARE: YUN KEUNG TSE D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry55071CA
21223G0001XGeneral Practice Dentistry0401412502VA

General Provider Information

NPI Number : 1114068905
Entity Type Code : Individual
Provider Name (Legal Business Name) : YUN KEUNG TSE D.D.S.
Provider Business Mailing Address
First Line : 5209 WHEAT RIDGE PL
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23059-5651
Country : US
Telephone Number : 804-833-3432
Fax Number :
Provider Business Practice Location Address
First Line : 131 PARK HILL DR
Second Line : SUITE A
City : FREDERICKSBURG
State : VA
Zip : 22401-3357
Country : US
Telephone Number : 540-373-0602
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 02/20/2016

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