Provider Demographics
NPI:1477628345
Name:HU, GEORGE P (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:P
Last Name:HU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 HIGHLAND AVE APT L5
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5440
Mailing Address - Country:US
Mailing Address - Phone:617-596-4915
Mailing Address - Fax:
Practice Address - Street 1:26 ESSEX ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1604
Practice Address - Country:US
Practice Address - Phone:617-542-6263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207061122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist