Provider Demographics
NPI:1780843334
Name:WU, CHUANJUN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHUANJUN
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 KENDALL CT
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1680
Mailing Address - Country:US
Mailing Address - Phone:978-987-0426
Mailing Address - Fax:
Practice Address - Street 1:65 HARRISON AVE
Practice Address - Street 2:SUITE 418
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1924
Practice Address - Country:US
Practice Address - Phone:617-338-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-07
Last Update Date:2015-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice