Provider Demographics
NPI:1245305069
Name:VO, TRUNG VINCENT TAN (DDS)
Entity type:Individual
Prefix:DR
First Name:TRUNG VINCENT
Middle Name:TAN
Last Name:VO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5233 FAIRMONT PKWY STE F
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3935
Mailing Address - Country:US
Mailing Address - Phone:281-998-2000
Mailing Address - Fax:281-998-0409
Practice Address - Street 1:5233 FAIRMONT PKWY STE F
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3935
Practice Address - Country:US
Practice Address - Phone:281-998-2000
Practice Address - Fax:281-998-0409
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist