Provider Demographics
NPI:1366657439
Name:VU, MAIAN QUOC (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAIAN
Middle Name:QUOC
Last Name:VU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5346
Mailing Address - Country:US
Mailing Address - Phone:518-584-6302
Mailing Address - Fax:518-584-6337
Practice Address - Street 1:403 LAKE AVE
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-5346
Practice Address - Country:US
Practice Address - Phone:518-584-6302
Practice Address - Fax:518-584-6337
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051509122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist