Provider Demographics
NPI: | 1053659888 |
---|---|
Name: | VICKI H.ZHU, D.M.D., PC |
Entity type: | Organization |
Organization Name: | VICKI H.ZHU, D.M.D., PC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | VICKI |
Authorized Official - Middle Name: | HUI |
Authorized Official - Last Name: | ZHU |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DMD |
Authorized Official - Phone: | 978-531-8911 |
Mailing Address - Street 1: | 6 ESSEX CENTER DR STE 204 |
Mailing Address - Street 2: | |
Mailing Address - City: | PEABODY |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 01960-2906 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 978-531-8911 |
Mailing Address - Fax: | 978-532-5520 |
Practice Address - Street 1: | 6 ESSEX CENTER DR STE 204 |
Practice Address - Street 2: | |
Practice Address - City: | PEABODY |
Practice Address - State: | MA |
Practice Address - Zip Code: | 01960-2906 |
Practice Address - Country: | US |
Practice Address - Phone: | 978-531-8911 |
Practice Address - Fax: | 978-532-5520 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-01-29 |
Last Update Date: | 2013-01-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MA | DN20801 | 261QD0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QD0000X | Ambulatory Health Care Facilities | Clinic/Center | Dental |