Provider Demographics
NPI:1144656471
Name:LEONARD AND MARIA FU PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:LEONARD AND MARIA FU PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-969-8452
Mailing Address - Street 1:515 SOUTH DR
Mailing Address - Street 2:STE 10B
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4204
Mailing Address - Country:US
Mailing Address - Phone:650-969-8452
Mailing Address - Fax:650-969-8599
Practice Address - Street 1:515 SOUTH DR
Practice Address - Street 2:STE 10B
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4204
Practice Address - Country:US
Practice Address - Phone:650-969-8452
Practice Address - Fax:650-969-8599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty