Provider Demographics
NPI:1629084892
Name:MA, YOUSHENG (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:YOUSHENG
Middle Name:
Last Name:MA
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HAVEN ST UNIT 303
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-2961
Mailing Address - Country:US
Mailing Address - Phone:781-944-4240
Mailing Address - Fax:781-944-4276
Practice Address - Street 1:2 HAVEN ST UNIT 303
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2961
Practice Address - Country:US
Practice Address - Phone:781-944-4240
Practice Address - Fax:781-944-4276
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA200061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice