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General NPI Number Information
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NPI Number | 1972002707
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Entity Type | Organization
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Legal Business Name | DR. VU DENTAL OFFICE, INC.
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Dates
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Enumeration Date | 02/07/2018
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 10660 SIERRA AVE STE J
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City | FONTANA
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State | CA
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Zip | 92337-7663
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Country | US
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Telephone | 909-428-0299
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Fax | 909-429-8504
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Provider Business Mailing Address
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Address Line | 10660 SIERRA AVE STE J
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City | FONTANA
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State | CA
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Zip | 92337-7663
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | DR. THAI QUOC VU
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Credential | DMD
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Telephone | 909-428-0299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 52788
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License Number State | CA
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