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General NPI Number Information
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NPI Number | 1215092218
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Entity Type | Individual
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Provider Name | DIEM DUY DO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 5220 LAPALCO BLVD
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City | MARRERO
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State | LA
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Zip | 70072-4248
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Country | US
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Telephone | 504-370-2229
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Fax | 504-340-9482
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Provider Business Mailing Address
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Address Line | 5220 LAPALCO BLVD
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City | MARRERO
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State | LA
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Zip | 70072-4248
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Country | US
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Telephone | 504-370-2229
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Fax | 504-340-9482
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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 | 7892
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License Number State | LA
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