Provider Demographics
NPI:1942566559
Name:VU, PRISCILLA LAN (DDS)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:LAN
Last Name:VU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9210 SUNBONNET DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3158
Mailing Address - Country:US
Mailing Address - Phone:281-997-9970
Mailing Address - Fax:
Practice Address - Street 1:9210 SUNBONNET DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3158
Practice Address - Country:US
Practice Address - Phone:281-997-9970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX180011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice