Provider Demographics
NPI:1609916766
Name:JUE, VINCENT M (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:M
Last Name:JUE
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 1:838 GRANT AVE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-1738
Mailing Address - Country:US
Mailing Address - Phone:415-982-8434
Mailing Address - Fax:415-982-8437
Practice Address - Street 1:838 GRANT AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-1738
Practice Address - Country:US
Practice Address - Phone:415-982-8434
Practice Address - Fax:415-982-8437
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25266122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist