Provider Demographics
NPI:1801061528
Name:KERRY WU DENTAL OFFICE PC
Entity type:Organization
Organization Name:KERRY WU DENTAL OFFICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:H
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-818-2613
Mailing Address - Street 1:127 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03064-2043
Mailing Address - Country:US
Mailing Address - Phone:603-889-6548
Mailing Address - Fax:
Practice Address - Street 1:127 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064-2043
Practice Address - Country:US
Practice Address - Phone:603-889-6548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03653122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty