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General NPI Number Information
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NPI Number | 1003005075
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Entity Type | Individual
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Provider Name | TOM VU DMD
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Gender | Male
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 4955 VAN NUYS BLVD SUITE #518
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City | SHERMAN OAKS
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State | CA
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Zip | 91403
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Country | US
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Telephone | 818-783-8891
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Fax | 818-783-2648
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Provider Business Mailing Address
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Address Line | 4955 VAN NUYS BLVD SUITE #518
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City | SHERMAN OAKS
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State | CA
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Zip | 91403
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Country | US
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Telephone | 818-783-8891
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Fax | 818-783-2648
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 54439
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License Number State | CA
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