Provider Demographics
NPI:1902855851
Name:ZENG, QUN
Entity Type:Individual
Prefix:DR
First Name:QUN
Middle Name:
Last Name:ZENG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SILVER LN
Mailing Address - Street 2:STE 238
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-1296
Mailing Address - Country:US
Mailing Address - Phone:860-569-1800
Mailing Address - Fax:860-569-1091
Practice Address - Street 1:800 SILVER LN
Practice Address - Street 2:STE 238
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06118-1296
Practice Address - Country:US
Practice Address - Phone:860-569-1800
Practice Address - Fax:860-569-1091
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT94381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice