Individual
FANG-YU SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3223 N BROAD ST, PHILADELPHIA, PA 19140-5007
(215) 531-3603
Mailing address
3223 N BROAD ST, PHILADELPHIA, PA 19140-5007
(215) 926-2350
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
019.032873
IL
1223P0700X
Prosthodontics
12013481A
IN
1223P0700X
Prosthodontics
Primary
RFD000042
PA
Other
Enumeration date
03/03/2021
Last updated
03/30/2021
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