Provider Demographics
NPI:1154462109
Name:VO, THACH NHU (DMD)
Entity Type:Individual
Prefix:
First Name:THACH
Middle Name:NHU
Last Name:VO
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 1:13297 MICHAEL RAINFORD CIR
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-2542
Mailing Address - Country:US
Mailing Address - Phone:714-530-4552
Mailing Address - Fax:714-530-4553
Practice Address - Street 1:895 E YORBA LINDA BLVD
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3695
Practice Address - Country:US
Practice Address - Phone:714-579-1567
Practice Address - Fax:714-579-1824
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA508411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice