# YU DENTAL GROUP, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Icy Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306588785
- **Authorized official:** DR. BOYD KING TUNG YU D.M.D. (OWNER)
- **Authorized official phone:** (657) 888-2693

## Contact information

- **Practice address:** 2843 E GRAND RIVER AVE STE 130, EAST LANSING, MI 48823-4989
- **Practice address phone:** (657) 888-2693
- **Mailing address:** 3901 QUARTERHORSE RD, EAST LANSING, MI 48823-6192
- **Mailing address phone:** (517) 366-0113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/07/2022
- **Last updated:** 04/07/2022