Provider Demographics
NPI:1821036609
Name:VO, THOMAS L (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:L
Last Name:VO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:509 OLIVE WAY
Mailing Address - Street 2:1117
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1720
Mailing Address - Country:US
Mailing Address - Phone:206-623-8405
Mailing Address - Fax:206-749-9093
Practice Address - Street 1:509 OLIVE WAY
Practice Address - Street 2:1117
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1720
Practice Address - Country:US
Practice Address - Phone:206-623-8405
Practice Address - Fax:206-749-9093
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WADE102851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice