Provider Demographics
NPI:1972609535
Name:TRUONG, QUYNHMAI (DDS)
Entity Type:Individual
Prefix:
First Name:QUYNHMAI
Middle Name:
Last Name:TRUONG
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 1:13607 PINE REACH DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-2743
Mailing Address - Country:US
Mailing Address - Phone:804-647-2784
Mailing Address - Fax:
Practice Address - Street 1:101 MASON ST
Practice Address - Street 2:
Practice Address - City:CREWE
Practice Address - State:VA
Practice Address - Zip Code:23930-1745
Practice Address - Country:US
Practice Address - Phone:434-645-9602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014106071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice