Basic Information
| Provider Information | |||||||||
| NPI: | 1487030466 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HU | ||||||||
| FirstName: | ERIC | ||||||||
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| Credential: | D.M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 36014 WRATTEN AVE, | ||||||||
| Address2: | |||||||||
| City: | KILLEEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7073447608 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7710 SIGHTSEEING RD | ||||||||
| Address2: | BLDG 2826 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319053764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065443103 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2015 | ||||||||
| LastUpdateDate: | 06/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223P0700X | 64521 | CA | Y | Dental Providers | Dentist | Prosthodontics | 122300000X | 64521 | CA | N | Dental Providers | Dentist |
No ID Information.