Provider Demographics
NPI:1972733970
Name:SUN, ALICE C (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:C
Last Name:SUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6042 BOLSA AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2443
Mailing Address - Country:US
Mailing Address - Phone:714-373-8787
Mailing Address - Fax:714-373-8787
Practice Address - Street 1:6042 BOLSA AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-2443
Practice Address - Country:US
Practice Address - Phone:714-373-8787
Practice Address - Fax:714-373-8787
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29760122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist