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General NPI Number Information
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NPI Number | 1184152852
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Entity Type | Organization
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Legal Business Name | TU'S DENTAL
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Dates
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Enumeration Date | 05/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2110 BATH AVE
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City | BROOKLYN
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State | NY
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Zip | 11214-4908
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Country | US
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Telephone | 202-460-4769
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Fax |
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Provider Business Mailing Address
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Address Line | 2110 BATH AVE
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City | BROOKLYN
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State | NY
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Zip | 11214-4908
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Country | US
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Telephone | 202-460-4769
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. TU ANH VU
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Credential | DMD
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Telephone | 202-460-4769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 059003-1
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License Number State | NY
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