Provider Demographics
NPI:1578744991
Name:UPLAND DENTAL IMPLANT & ORTHODONTICS
Entity Type:Organization
Organization Name:UPLAND DENTAL IMPLANT & ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YUEN-SIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-678-9888
Mailing Address - Street 1:34859 FREDERICK ST STE 106
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-7007
Mailing Address - Country:US
Mailing Address - Phone:951-678-9888
Mailing Address - Fax:951-678-6786
Practice Address - Street 1:34859 FREDERICK ST
Practice Address - Street 2:STE 106
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-7007
Practice Address - Country:US
Practice Address - Phone:951-678-9888
Practice Address - Fax:951-678-6786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes126800000XDental ProvidersDental AssistantGroup - Single Specialty