Provider Demographics
NPI:1316388184
Name:LE VU DENTAL CORPORATION
Entity Type:Organization
Organization Name:LE VU DENTAL CORPORATION
Other - Org Name:BRUCEVILLE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THUY NGA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-670-0124
Mailing Address - Street 1:7501 HOSPITAL DR
Mailing Address - Street 2:#202
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5405
Mailing Address - Country:US
Mailing Address - Phone:916-682-9031
Mailing Address - Fax:916-209-8744
Practice Address - Street 1:7501 HOSPITAL DR
Practice Address - Street 2:#202
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5405
Practice Address - Country:US
Practice Address - Phone:916-682-9031
Practice Address - Fax:916-209-8744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38766122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty