Organization
SHUN HSU DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHUN CHING HSU DDS (OWNER/DENTIST)
(678) 512-0261
Entity
Organization
Contact information
Practice address
1132 ATHENS HWY, SUITE 207, GRAYSON, GA 30017-1710
(678) 512-0261
(678) 512-0262
Mailing address
6307 ROBINS TRCE, STONE MOUNTAIN, GA 30087-4979
(678) 512-0261
(678) 512-0262
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012882
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073611224
INDIVIDUAL NPI #
GA
05
—
684739693B
—
GA
Enumeration date
07/31/2012
Last updated
07/31/2012
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