MEDICARE: THACH NHU VO DMD , HANHNGOC NHU VO DMD,INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	50841	CA

General Provider Information

NPI Number	:	1023267168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THACH NHU VO DMD , HANHNGOC NHU VO DMD,INC

Provider Business Mailing Address
First Line	:	14740 PIPELINE AVE
Second Line	:	SUITE C
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-1293
Country	:	US
Telephone Number	:	909-393-7707
Fax Number	:	909-393-7708

Provider Business Practice Location Address
First Line	:	14740 PIPELINE AVE
Second Line	:	SUITE C
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-1293
Country	:	US
Telephone Number	:	909-393-7707
Fax Number	:	909-393-7708

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THACH NHU VO
Credential	:	DMD
Telephone Number	:	714-300-8877

Provider Enumeration Date	:	09/12/2008
Last Update Date	:	09/12/2008

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