Provider Demographics
NPI:1497132393
Name:VO, DIANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:VO
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 1:3D DEN BN 3MLG DET H
Mailing Address - Street 2:UNIT 38452 BOX 259
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96385-0259
Mailing Address - Country:US
Mailing Address - Phone:0804-093-3103
Mailing Address - Fax:
Practice Address - Street 1:3D DEN BN 3MLG DET H
Practice Address - Street 2:UNIT 38452 BOX 259
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96385
Practice Address - Country:US
Practice Address - Phone:0804-093-3103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014146481223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics