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General NPI Number Information
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NPI Number | 1871845792
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Entity Type | Organization
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Legal Business Name | VINH NGO DDS PLLC
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Dates
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Enumeration Date | 10/03/2012
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Last Update Date | 10/03/2012
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Provider Practice Location Address
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Address Line | 1505 E RIO GRANDE ST
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City | VICTORIA
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State | TX
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Zip | 77901-7396
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Country | US
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Telephone | 212-671-2213
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Fax |
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Provider Business Mailing Address
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Address Line | 4055 HOGAN DR 3102
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City | TYLER
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State | TX
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Zip | 75709-6930
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Country | US
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Telephone | 212-671-2213
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | VINH NGO
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Credential |
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Telephone | 212-671-2213
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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 | 27025
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License Number State | TX
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