Provider Demographics
NPI:1972984789
Name:ATHENA VU DDS PLLC 2
Entity Type:Organization
Organization Name:ATHENA VU DDS PLLC 2
Other - Org Name:UPTOWN DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATHENA
Authorized Official - Middle Name:
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-500-1355
Mailing Address - Street 1:400 S TRYON
Mailing Address - Street 2:SUITE M4
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28285-1900
Mailing Address - Country:US
Mailing Address - Phone:704-375-7711
Mailing Address - Fax:
Practice Address - Street 1:400 SOUTH TRYON STREET
Practice Address - Street 2:SUITE M4
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28285
Practice Address - Country:US
Practice Address - Phone:704-375-7711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty