Provider Demographics
NPI:1407083272
Name:VIELMANN, VIVIAN MONNETTE (RDH,BS)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:MONNETTE
Last Name:VIELMANN
Suffix:
Gender:F
Credentials:RDH,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 E FM 544
Mailing Address - Street 2:SUITE 915
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4056
Mailing Address - Country:US
Mailing Address - Phone:972-423-0415
Mailing Address - Fax:
Practice Address - Street 1:305 E FM 544
Practice Address - Street 2:SUITE 915
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4056
Practice Address - Country:US
Practice Address - Phone:972-423-0415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8957124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist