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General NPI Number Information
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NPI Number | 1992853659
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Entity Type | Individual
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Provider Name | MINH J THAI
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 12/29/2010
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Provider Practice Location Address
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Address Line | 1400 GROVE ST
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City | DENVER
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State | CO
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Zip | 80204-2229
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Country | US
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Telephone | 303-825-2295
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Fax |
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Provider Business Mailing Address
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Address Line | 201 W 8TH ST SUITE 810
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City | PUEBLO
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State | CO
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Zip | 81003-3038
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Country | US
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Telephone | 719-562-4447
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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 | DEN-8430
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License Number State | CO
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