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NPI Code Detail

MEDICARE: MAN VO AND TINA VO DDS

MEDICARE: MAN VO AND TINA VO DDS
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
1122300000XDentist46227CA
2122300000XDentist47009CA

General Provider Information

NPI Number : 1689057614
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAN VO AND TINA VO DDS
Provider Business Mailing Address
First Line : 5013 ARLINGTON AVE STE A
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-2792
Country : US
Telephone Number : 951-688-4772
Fax Number : 951-688-0226
Provider Business Practice Location Address
First Line : 5013 ARLINGTON AVE STE A
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-2792
Country : US
Telephone Number : 951-688-4772
Fax Number : 951-688-0226
Authorized Official
Title or Position : GENERAL PARTNER
Name : DR. MAN MINH VO
Credential : DDS
Telephone Number : 951-688-4772
Provider Enumeration Date : 07/08/2015
Last Update Date : 07/08/2015

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