Healthcare Provider Details

I. General information

NPI: 1891912002
Provider Name (Legal Business Name): ANTHONY T. VUONG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 03/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 2ND AVE RM 812
NEW YORK NY
10017-9222
US

IV. Provider business mailing address

800 2ND AVE RM 812
NEW YORK NY
10017-9222
US

V. Phone/Fax

Practice location:
  • Phone: 212-717-5341
  • Fax:
Mailing address:
  • Phone: 212-717-5341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number043589
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: