Provider Demographics
NPI:1457901696
Name:FU, ERIC BRYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BRYAN
Last Name:FU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 W CHEYENNE RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3019
Mailing Address - Country:US
Mailing Address - Phone:415-401-5625
Mailing Address - Fax:
Practice Address - Street 1:5150 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4002
Practice Address - Country:US
Practice Address - Phone:719-413-8133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1044371223G0001X
CO002058181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice