Provider Demographics
NPI:1003958489
Name:DUONG, VU QUOC (DDS)
Entity Type:Individual
Prefix:
First Name:VU
Middle Name:QUOC
Last Name:DUONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6771 WESTMINSTER BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-3700
Mailing Address - Country:US
Mailing Address - Phone:714-898-3707
Mailing Address - Fax:
Practice Address - Street 1:6771 WESTMINSTER BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3700
Practice Address - Country:US
Practice Address - Phone:714-898-3707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA391181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice