Provider Demographics
NPI:1487965430
Name:CHU, CHRISTY YUJU (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:YUJU
Last Name:CHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 CANCO RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-4303
Mailing Address - Country:US
Mailing Address - Phone:207-874-1025
Mailing Address - Fax:
Practice Address - Street 1:177 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7016
Practice Address - Country:US
Practice Address - Phone:207-874-1025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME4194122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist