Individual
ANDREW SUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3031 W MARCH LN, STOCKTON, CA 95219-6500
(209) 390-9516
Mailing address
242 LATERA CT, SAN RAMON, CA 94582-4680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
105121
CA
Other
Enumeration date
08/21/2020
Last updated
08/21/2020
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