Individual
EDMUND S WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2171 68TH ST, BROOKLYN, NY 11204-4716
(347) 713-1828
Mailing address
2171 68TH ST, BROOKLYN, NY 11204-4716
(347) 713-1828
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
059991-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2017
Last updated
04/07/2019
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