Provider Demographics
NPI:1720296080
Name:HSUE, HENRY SCOTT (DMD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:SCOTT
Last Name:HSUE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19115 112TH AVE NE
Mailing Address - Street 2:SUITE B101
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-0043
Mailing Address - Country:US
Mailing Address - Phone:425-890-0465
Mailing Address - Fax:
Practice Address - Street 1:19115 112TH AVE NE
Practice Address - Street 2:SUITE B101
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-0043
Practice Address - Country:US
Practice Address - Phone:425-890-0465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60076406122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist