Provider Demographics
NPI:1457035081
Name:VU, TUAN DUC (DDS)
Entity Type:Individual
Prefix:
First Name:TUAN
Middle Name:DUC
Last Name:VU
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 1:4055 HOGAN DR APT 1203
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75709-6939
Mailing Address - Country:US
Mailing Address - Phone:817-666-5815
Mailing Address - Fax:
Practice Address - Street 1:8942 S BROADWAY AVE STE 128
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-5443
Practice Address - Country:US
Practice Address - Phone:903-405-1552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39517122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist