Organization
JIM LU AND SHANE LU DDS PLLC
Active
Other names
Burlington Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIM LU DDS (OWNER)
(706) 254-4191
Entity
Organization
Contact information
Practice address
2430 S CHURCH ST STE B, BURLINGTON, NC 27215
(336) 639-7101
Mailing address
322 S DAVIE ST APT 208, GREENSBORO, NC 27401-2856
(706) 254-4191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10319
NC
1223G0001X
General Practice Dentistry
9969
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922486703
—
NC
05
—
1952719353
—
NC
Enumeration date
07/30/2018
Last updated
07/30/2018
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