Individual
DR. KENNETH JINGEN WU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10782 HICKORY RIDGE RD, COLUMBIA, MD 21044-3646
(410) 730-6001
(410) 992-4452
Mailing address
5128 WILLET BRIDGE RD, BETHESDA, MD 20816-2804
(202) 681-6688
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
14858
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2009
Last updated
09/17/2015
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