Provider Demographics
NPI:1417512278
Name:TUONGTHUY P HA DDS
Entity Type:Organization
Organization Name:TUONGTHUY P HA DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TUONGTHUY
Authorized Official - Middle Name:PHU
Authorized Official - Last Name:HA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-248-4503
Mailing Address - Street 1:1959 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-3816
Mailing Address - Country:US
Mailing Address - Phone:562-432-9883
Mailing Address - Fax:562-684-0302
Practice Address - Street 1:1959 E 4TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-3816
Practice Address - Country:US
Practice Address - Phone:562-432-9883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty