Provider Demographics
NPI:1720520604
Name:ALPHA DENTAL MARION - MING YU DDS LLC
Entity Type:Organization
Organization Name:ALPHA DENTAL MARION - MING YU DDS LLC
Other - Org Name:ALPHA DENTAL MARION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTAILING
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-231-8000
Mailing Address - Street 1:161 JAMES WAY
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-5892
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:161 JAMES WAY
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-5892
Practice Address - Country:US
Practice Address - Phone:614-231-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-09
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty