Provider Demographics
NPI:1972741940
Name:DIEUTRANG NU TON DDS A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DIEUTRANG NU TON DDS A PROFESSIONAL CORPORATION
Other - Org Name:BIG SMILES DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:D.D.S
Authorized Official - Prefix:
Authorized Official - First Name:DIEUTRANG
Authorized Official - Middle Name:NU
Authorized Official - Last Name:TON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-725-3740
Mailing Address - Street 1:1547 SARATOGA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-4938
Mailing Address - Country:US
Mailing Address - Phone:408-725-3740
Mailing Address - Fax:408-725-7928
Practice Address - Street 1:1547 SARATOGA AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-4938
Practice Address - Country:US
Practice Address - Phone:408-725-3740
Practice Address - Fax:408-725-7928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-29
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty