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General NPI Number Information
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NPI Number | 1811705866
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Entity Type | Organization
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Legal Business Name | TDH DENTAL PLLC
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 5959 SHALLOWFORD RD STE 539
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2240
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Country | US
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Telephone | 423-499-8007
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 173
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City | HIXSON
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State | TN
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Zip | 37343-0173
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Country | US
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Telephone | 650-283-5130
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | THUAN-VU DINH HO
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Credential | DMD
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Telephone | 650-283-5130
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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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