MEDICARE: CHRISTINA HSU, DDS, PLLC

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
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1194201087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTINA HSU, DDS, PLLC

Provider Business Mailing Address
First Line	:	17 STRATHMORE RD APT 2
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02445-1967
Country	:	US
Telephone Number	:	646-327-3152
Fax Number	:

Provider Business Practice Location Address
First Line	:	637 WASHINGTON ST
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-1606
Country	:	US
Telephone Number	:	617-782-5030
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINA HSU
Credential	:	DDS
Telephone Number	:	646-327-3152

Provider Enumeration Date	:	07/14/2018
Last Update Date	:	07/14/2018

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