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NPI Code Detail

MEDICARE: FU DENTAL CORP

MEDICARE: FU DENTAL CORP
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 Dentistry47682CA
21223G0001XGeneral Practice Dentistry47620CA

General Provider Information

NPI Number : 1942321476
Entity Type Code : Organization
Provider Name (Legal Business Name) : FU DENTAL CORP
Provider Business Mailing Address
First Line : 6552 BOLSA AVE STE J
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647-2656
Country : US
Telephone Number : 714-540-8547
Fax Number :
Provider Business Practice Location Address
First Line : 6552 BOLSA AVE STE J
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647-2656
Country : US
Telephone Number : 714-540-8547
Fax Number :
Authorized Official
Title or Position : OFFICIER
Name : DR. NINA X YU
Credential : DDS
Telephone Number : 714-540-8547
Provider Enumeration Date : 04/02/2007
Last Update Date : 09/18/2014

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Directions to “FU DENTAL CORP ” Practice Location

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