Provider Demographics
NPI:1407958671
Name:SUN, FANGBIN (DDS MS)
Entity Type:Individual
Prefix:MR
First Name:FANGBIN
Middle Name:
Last Name:SUN
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 WEST HILL ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-4724
Mailing Address - Country:US
Mailing Address - Phone:810-232-7070
Mailing Address - Fax:810-232-9830
Practice Address - Street 1:1111 WEST HILL ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-4724
Practice Address - Country:US
Practice Address - Phone:810-232-7070
Practice Address - Fax:810-232-9830
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010166361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics