Provider Demographics
NPI:1689330359
Name:SUE DINH, DDS, PLC
Entity Type:Organization
Organization Name:SUE DINH, DDS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NGOC-CAM
Authorized Official - Middle Name:KHAC
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-526-0579
Mailing Address - Street 1:19576 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1406
Mailing Address - Country:US
Mailing Address - Phone:832-526-0579
Mailing Address - Fax:
Practice Address - Street 1:1083 E M 21
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-9014
Practice Address - Country:US
Practice Address - Phone:832-526-0579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental