Organization
DR WU PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JO ANN RICE (CREDENTIALING MANAGER)
(470) 881-8679
Entity
Organization
Contact information
Practice address
1525 FAIR OAKS AVE, SOUTH PASADENA, CA 91030-3835
(626) 403-6500
Mailing address
2970 BRANDYWINE RD STE 200, ATLANTA, GA 30341-5549
(770) 692-1000
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
12/14/2021
Last updated
12/14/2021
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