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Individual

DR. LINDA HUNPONU-WUSU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
639 MOUNT PROSPECT AVE, NEWARK, NJ 07104-3109
(973) 481-3900
(973) 481-2999
Mailing address
372 MOUNT PROSPECT AVE, APT F7, NEWARK, NJ 07104-2110
(862) 237-9361

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
053630
NY
122300000X
Dentist
Primary
22DI02412201
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00665274
NY
05
0305677
NJ
01
13-2960287
TAX ID
NY
Enumeration date
03/10/2008
Last updated
10/09/2012
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