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General NPI Number Information
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NPI Number | 1417512278
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Entity Type | Organization
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Legal Business Name | TUONGTHUY P HA DDS
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 05/07/2019
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Provider Practice Location Address
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Address Line | 1959 E 4TH ST
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City | LONG BEACH
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State | CA
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Zip | 90802-3816
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Country | US
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Telephone | 562-432-9883
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Fax |
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Provider Business Mailing Address
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Address Line | 1959 E 4TH ST
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City | LONG BEACH
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State | CA
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Zip | 90802-3816
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Country | US
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Telephone | 562-432-9883
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Fax | 562-684-0302
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Authorized Official
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Title or Position | OWNER
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Name | TUONGTHUY PHU HA
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Credential | DDS
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Telephone | 213-248-4503
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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