Provider Demographics
NPI:1750502472
Name:PETER C. WU, DDS, CORP.
Entity Type:Organization
Organization Name:PETER C. WU, DDS, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-446-6618
Mailing Address - Street 1:622 W DUARTE RD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7606
Mailing Address - Country:US
Mailing Address - Phone:626-446-6618
Mailing Address - Fax:626-446-9661
Practice Address - Street 1:622 W DUARTE RD
Practice Address - Street 2:SUITE #201
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7606
Practice Address - Country:US
Practice Address - Phone:626-446-6618
Practice Address - Fax:626-446-9661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty