Provider Demographics
NPI:1417081589
Name:VU, QUOC (DDS)
Entity Type:Individual
Prefix:
First Name:QUOC
Middle Name:
Last Name:VU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4043 TRINITY MILLS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287
Mailing Address - Country:US
Mailing Address - Phone:972-306-2121
Mailing Address - Fax:
Practice Address - Street 1:4043 TRINITY MILLS RD STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6757
Practice Address - Country:US
Practice Address - Phone:972-306-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX223981223G0001X
CA64142122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1417081589OtherPERSONAL NPI