MEDICARE: DR. VU D NGO D.M.D.

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	DN17402	FL

General Provider Information

NPI Number	:	1609037761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VU D NGO D.M.D.

Provider Business Mailing Address
First Line	:	5061 OKEECHOBEE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-4533
Country	:	US
Telephone Number	:	561-296-3088
Fax Number	:	561-202-6978

Provider Business Practice Location Address
First Line	:	5061 OKEECHOBEE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-4533
Country	:	US
Telephone Number	:	561-296-3088
Fax Number	:	561-202-6978

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2008
Last Update Date	:	06/23/2008

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