Provider Demographics
NPI:1063505451
Name:LUU, THUC H (DMD)
Entity Type:Individual
Prefix:DR
First Name:THUC
Middle Name:H
Last Name:LUU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 HOLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519
Mailing Address - Country:US
Mailing Address - Phone:925-671-6812
Mailing Address - Fax:
Practice Address - Street 1:902 E HAMMER LN 5
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210
Practice Address - Country:US
Practice Address - Phone:209-957-9500
Practice Address - Fax:209-957-9508
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA546421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice