Provider Demographics
NPI:1043208770
Name:KZ HSUE DDS PLLC
Entity Type:Organization
Organization Name:KZ HSUE DDS PLLC
Other - Org Name:DBA TLC DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KUZI
Authorized Official - Middle Name:S
Authorized Official - Last Name:HSUE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-488-1480
Mailing Address - Street 1:22703 BOTHELL EVERETT HWY
Mailing Address - Street 2:SUITE E
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021
Mailing Address - Country:US
Mailing Address - Phone:425-488-1480
Mailing Address - Fax:425-489-9997
Practice Address - Street 1:22703 BOTHELL EVERETT HWY
Practice Address - Street 2:SUITE E
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021
Practice Address - Country:US
Practice Address - Phone:425-488-1480
Practice Address - Fax:425-489-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA71581223G0001X
WADE00067361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty