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General NPI Number Information
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NPI Number | 1164737540
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Entity Type | Individual
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Provider Name | DAVID TIEN SI VO DDS
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Gender | Male
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 275 WEST PRINCETON DR. SUITE 100
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City | PRINCETON
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State | TX
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Zip | 75407
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Country | US
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Telephone | 972-736-1000
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Fax | 972-736-1002
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Provider Business Mailing Address
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Address Line | 275 WEST PRINCETON DR. SUITE 100
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City | PRINCETON
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State | TX
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Zip | 75407
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Country | US
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Telephone | 972-736-1000
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Fax | 972-736-1002
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 25850
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 6282
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License Number State | NV
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