Provider Demographics
NPI:1992717987
Name:HSU, CAROLINE (DMD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:HSU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5422
Mailing Address - Country:US
Mailing Address - Phone:215-616-0609
Mailing Address - Fax:215-616-0643
Practice Address - Street 1:1620 S BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5422
Practice Address - Country:US
Practice Address - Phone:215-616-0609
Practice Address - Fax:215-616-0643
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0352631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice