Individual
DR. LISA G WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
57950 LEAVENWORTH ST BLDG 250, MCCONNELL AFB, KS 67221-3505
(316) 759-6300
Mailing address
13631 NIMES CT, CHINO HILLS, CA 91709-1382
(909) 548-2289
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
64929
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D14112
MN
124Q00000X
Dental Hygienist
25146
CA
Other
Enumeration date
08/10/2010
Last updated
06/12/2024
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