Provider Demographics
NPI:1174013833
Name:HERBERT HUNG VU 3
Entity Type:Organization
Organization Name:HERBERT HUNG VU 3
Other - Org Name:PREMIER DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:HUNG
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PLLC
Authorized Official - Phone:704-982-5516
Mailing Address - Street 1:1122 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-2903
Mailing Address - Country:US
Mailing Address - Phone:704-982-5516
Mailing Address - Fax:704-983-8985
Practice Address - Street 1:1122 N 6TH ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-2903
Practice Address - Country:US
Practice Address - Phone:704-982-5516
Practice Address - Fax:704-983-8985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1730477977Medicaid