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General NPI Number Information
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NPI Number | 1194099903
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Entity Type | Organization
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Legal Business Name | TRIEU SMILES LLC
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 3708 4TH ST SUITE 103
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City | HARVEY
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State | LA
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Zip | 70058-2856
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Country | US
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Telephone | 504-309-7830
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Fax | 504-309-7833
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Provider Business Mailing Address
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Address Line | 3708 4TH ST SUITE 103
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City | HARVEY
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State | LA
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Zip | 70058-2856
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Country | US
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Telephone | 504-309-7830
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Fax | 504-309-7833
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JULIA PHUNG TRIEU
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Credential | D.D.S.
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Telephone | 504-309-7830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 6022
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License Number State | LA
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