Provider Demographics
NPI:1275632853
Name:HSU, G-HONG ROBERT (DDS, MS)
Entity Type:Individual
Prefix:
First Name:G-HONG
Middle Name:ROBERT
Last Name:HSU
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:39572 STEVENSON PL
Mailing Address - Street 2:SUITE 121
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3075
Mailing Address - Country:US
Mailing Address - Phone:510-794-6600
Mailing Address - Fax:510-794-1525
Practice Address - Street 1:39572 STEVENSON PL
Practice Address - Street 2:SUITE 121
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3075
Practice Address - Country:US
Practice Address - Phone:510-794-6600
Practice Address - Fax:510-794-1525
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458761223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics