Provider Demographics
NPI:1073650651
Name:DUONG, ANH VAN (DDS)
Entity Type:Individual
Prefix:MR
First Name:ANH
Middle Name:VAN
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 1:7746 PARK PLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-4528
Mailing Address - Country:US
Mailing Address - Phone:713-649-4800
Mailing Address - Fax:713-654-1700
Practice Address - Street 1:7746 PARK PLACE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-4528
Practice Address - Country:US
Practice Address - Phone:713-649-4800
Practice Address - Fax:713-654-1700
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX151431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice