Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN 60464161 | WA |
NPI | 1750751822 |
---|---|
Provider Name | Harvey Cu |
First Address | Bremerton, WA 98310 |
Second Address | Bremerton, WA 98310-4680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2015 |
Last Update Date | 02/10/2015 |