Provider Demographics
NPI:1528461142
Name:PHILIP W AU DDS INC
Entity type:Organization
Organization Name:PHILIP W AU DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:WING SHUN
Authorized Official - Last Name:AU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-446-2879
Mailing Address - Street 1:75 N SANTA ANITA AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3112
Mailing Address - Country:US
Mailing Address - Phone:626-446-2879
Mailing Address - Fax:
Practice Address - Street 1:75 N SANTA ANITA AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3112
Practice Address - Country:US
Practice Address - Phone:626-446-2879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-28
Last Update Date:2014-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38249122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty