Provider Demographics
NPI:1700602851
Name:BOIHOANG T VU DDS LLC
Entity type:Organization
Organization Name:BOIHOANG T VU DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-919-3074
Mailing Address - Street 1:12A WESTBANK EXPY STE 200
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-3659
Mailing Address - Country:US
Mailing Address - Phone:504-362-1776
Mailing Address - Fax:504-362-3400
Practice Address - Street 1:12A WESTBANK EXPY STE 200
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-3659
Practice Address - Country:US
Practice Address - Phone:504-362-1776
Practice Address - Fax:504-362-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty