Provider Demographics
NPI:1598811507
Name:HLA, TUN (D D S)
Entity Type:Individual
Prefix:DR
First Name:TUN
Middle Name:
Last Name:HLA
Suffix:
Gender:M
Credentials:D D S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15070 HESPERIAN BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-3546
Mailing Address - Country:US
Mailing Address - Phone:510-481-8566
Mailing Address - Fax:510-481-8568
Practice Address - Street 1:15070 HESPERIAN BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-3546
Practice Address - Country:US
Practice Address - Phone:510-481-8566
Practice Address - Fax:510-481-8568
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39811122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist