Provider Demographics
NPI:1922308915
Name:WALLY HUI DDS CORP
Entity Type:Organization
Organization Name:WALLY HUI DDS CORP
Other - Org Name:DIGITAL DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-448-6800
Mailing Address - Street 1:3328 S. DEL MAR AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2330
Mailing Address - Country:US
Mailing Address - Phone:626-288-9328
Mailing Address - Fax:626-288-9320
Practice Address - Street 1:3328 S. DEL MAR AVE
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2330
Practice Address - Country:US
Practice Address - Phone:626-288-9328
Practice Address - Fax:626-288-9320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51339302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization