Provider Demographics
NPI:1164737540
Name:VO, DAVID TIEN SI (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:TIEN SI
Last Name:VO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:275 WEST PRINCETON DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PRINCETON
Mailing Address - State:TX
Mailing Address - Zip Code:75407
Mailing Address - Country:US
Mailing Address - Phone:972-736-1000
Mailing Address - Fax:972-736-1002
Practice Address - Street 1:275 WEST PRINCETON DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:PRINCETON
Practice Address - State:TX
Practice Address - Zip Code:75407
Practice Address - Country:US
Practice Address - Phone:972-736-1000
Practice Address - Fax:972-736-1002
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX258501223P0221X
NV62821223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX213300105Medicaid
TX213300101Medicaid
TX213300102Medicaid
TX213300103Medicaid
TX213300107Medicaid
TX213300104Medicaid
TX213300106Medicaid