Healthcare Provider Details

I. General information

NPI: 1326458795
Provider Name (Legal Business Name): VUONG T. DO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2014
Last Update Date: 10/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9770 S MARYLAND PKWY #8
LAS VEGAS NV
89183-7142
US

IV. Provider business mailing address

9770 S MARYLAND PKWY #8
LAS VEGAS NV
89183-7142
US

V. Phone/Fax

Practice location:
  • Phone: 702-463-7300
  • Fax: 702-754-0229
Mailing address:
  • Phone: 702-463-7300
  • Fax: 702-754-0229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4791
License Number StateNV

VIII. Authorized Official

Name: DR. VUONG DO
Title or Position: OWNER
Credential:
Phone: 214-417-3713