Individual
TIFFANY WU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5262 E BEVERLY BLVD, LOS ANGELES, CA 90022-2002
(323) 887-0088
Mailing address
406 E FAIRVIEW AVENUE, SAN GABRIEL, CA 91776-2002
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
64331
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/04/2014
Last updated
03/17/2018
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