Provider Demographics
NPI:1265534358
Name:LY, DIEU THUY (DMD)
Entity type:Individual
Prefix:
First Name:DIEU
Middle Name:THUY
Last Name:LY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:73 PRINCETON ST
Mailing Address - Street 2:STE 202
Mailing Address - City:N CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863
Mailing Address - Country:US
Mailing Address - Phone:978-251-1515
Mailing Address - Fax:978-251-1616
Practice Address - Street 1:73 PRINCETON ST
Practice Address - Street 2:STE 202
Practice Address - City:N CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863
Practice Address - Country:US
Practice Address - Phone:978-251-1515
Practice Address - Fax:978-251-1616
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA187721223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics