Provider Demographics
NPI:1104035963
Name:WU, BEN (DDS, PHD)
Entity type:Individual
Prefix:DR
First Name:BEN
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 FIRST ST STE 17
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02142-1292
Mailing Address - Country:US
Mailing Address - Phone:617-892-8266
Mailing Address - Fax:
Practice Address - Street 1:245 FIRST ST STE 17
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02142-1292
Practice Address - Country:US
Practice Address - Phone:617-892-8266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN186271223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics