Provider Demographics
NPI:1407045156
Name:WU, EMMA Y, (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:Y,
Last Name:WU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3425
Mailing Address - Country:US
Mailing Address - Phone:978-774-0725
Mailing Address - Fax:978-774-6503
Practice Address - Street 1:2 ORCHARD LN
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3425
Practice Address - Country:US
Practice Address - Phone:978-774-0725
Practice Address - Fax:978-774-6503
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA188681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice