Provider Demographics
NPI:1457792236
Name:KUANG, SHU-ZHEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHU-ZHEN
Middle Name:
Last Name:KUANG
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 1:2401 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 1 A8
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3010
Mailing Address - Country:US
Mailing Address - Phone:215-765-5281
Mailing Address - Fax:
Practice Address - Street 1:2401 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 1 A8
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3010
Practice Address - Country:US
Practice Address - Phone:215-765-5281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0394941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice