Provider Demographics
NPI:1821076944
Name:VO, THUVAN THI (DMD)
Entity Type:Individual
Prefix:DR
First Name:THUVAN
Middle Name:THI
Last Name:VO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10722 KETCHUM VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7185
Mailing Address - Country:US
Mailing Address - Phone:813-671-0675
Mailing Address - Fax:813-671-0695
Practice Address - Street 1:10722 KETCHUM VALLEY DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-7185
Practice Address - Country:US
Practice Address - Phone:813-671-0675
Practice Address - Fax:813-670-0695
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013137122300000X
FLDN18603122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA145902291AMedicaid