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General NPI Number Information
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NPI Number | 1811033517
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Entity Type | Individual
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Provider Name | BAOCHAU THUY DUONG D.D.S
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Gender | Female
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 15751 BROOKHURST ST STE 129
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City | WESTMINSTER
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State | CA
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Zip | 92683-7578
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Country | US
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Telephone | 714-531-7130
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1832
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-1832
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Country | US
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Telephone | 562-533-0169
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 55112
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License Number State | CA
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