Provider Demographics
NPI:1659406205
Name:WU, ROSEMARY (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:
Last Name:WU
Suffix:
Gender:F
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 1:2428 PROFESSIONAL DR
Mailing Address - Street 2:STE. 100
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-7774
Mailing Address - Country:US
Mailing Address - Phone:916-786-6585
Mailing Address - Fax:916-786-7542
Practice Address - Street 1:2428 PROFESSIONAL DR
Practice Address - Street 2:STE. 100
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-7774
Practice Address - Country:US
Practice Address - Phone:916-786-6585
Practice Address - Fax:916-786-7542
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524831223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics