Provider Demographics
NPI:1477781037
Name:VO, TOAN T (DMD)
Entity Type:Individual
Prefix:DR
First Name:TOAN
Middle Name:T
Last Name:VO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 ELEGANTE CT
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-1771
Mailing Address - Country:US
Mailing Address - Phone:404-550-7148
Mailing Address - Fax:678-985-8297
Practice Address - Street 1:3689 UNION AVE
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1723
Practice Address - Country:US
Practice Address - Phone:404-762-1554
Practice Address - Fax:404-762-8574
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0139221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice