Provider Demographics
NPI:1932350733
Name:CU, ALBERT J (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:J
Last Name:CU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 W. TEXAS ST.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533
Mailing Address - Country:US
Mailing Address - Phone:707-429-4385
Mailing Address - Fax:707-429-4386
Practice Address - Street 1:1955 TEXAS ST STE 2
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4462
Practice Address - Country:US
Practice Address - Phone:707-429-4385
Practice Address - Fax:707-429-4386
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39782122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist