Provider Demographics
NPI:1871756775
Name:WU, EVERETT (DMD)
Entity type:Individual
Prefix:DR
First Name:EVERETT
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E TURKEYFOOT LAKE RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5365
Mailing Address - Country:US
Mailing Address - Phone:330-253-3198
Mailing Address - Fax:330-253-9812
Practice Address - Street 1:1600 E TURKEYFOOT LAKE RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5365
Practice Address - Country:US
Practice Address - Phone:330-253-3198
Practice Address - Fax:330-253-9812
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300228361223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty