Provider Demographics
NPI:1245539907
Name:TRIEU, JULIA PHUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:PHUNG
Last Name:TRIEU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3708 4TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2856
Mailing Address - Country:US
Mailing Address - Phone:504-309-7830
Mailing Address - Fax:504-309-7833
Practice Address - Street 1:3708 4TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2856
Practice Address - Country:US
Practice Address - Phone:504-309-7830
Practice Address - Fax:504-309-7833
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA60221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics