Provider Demographics
NPI:1649395609
Name:TON, VINH THAT (DMD)
Entity Type:Individual
Prefix:DR
First Name:VINH
Middle Name:THAT
Last Name:TON
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 1:12181 CANDY LN
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-2705
Mailing Address - Country:US
Mailing Address - Phone:714-251-1955
Mailing Address - Fax:
Practice Address - Street 1:2005 KNIGHT LANE
Practice Address - Street 2:BLDG H NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAF
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32212-0140
Practice Address - Country:US
Practice Address - Phone:760-725-7479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21742122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist