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General NPI Number Information
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NPI Number | 1487923967
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Entity Type | Organization
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Legal Business Name | MINH THAI DDS, PC
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Dates
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Enumeration Date | 12/29/2011
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | 2300 E 120TH AVE STE 104
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City | THORNTON
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State | CO
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Zip | 80233-1441
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Country | US
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Telephone | 303-653-3020
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 E 120TH AVE STE 104
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City | THORNTON
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State | CO
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Zip | 80233-1441
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Country | US
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Telephone | 303-254-8828
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. MINH J THAI
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Credential | DDS
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Telephone | 303-254-8828
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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 | 8430
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License Number State | CO
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