Healthcare Provider Details

I. General information

NPI: 1316565864
Provider Name (Legal Business Name): ANTHONY T. VUONG DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2020
Last Update Date: 07/10/2020
Certification Date: 07/10/2020
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: 908-533-4386
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. NIKHIL SAHA
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 908-533-4386