Provider Demographics
NPI:1700927944
Name:MAI, THUY T (DMD)
Entity Type:Individual
Prefix:DR
First Name:THUY
Middle Name:T
Last Name:MAI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-2162
Mailing Address - Country:US
Mailing Address - Phone:251-473-5705
Mailing Address - Fax:251-479-4709
Practice Address - Street 1:2727 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-2162
Practice Address - Country:US
Practice Address - Phone:251-473-5705
Practice Address - Fax:251-479-4709
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL53861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51524786OtherAL BLUE CROSS BLUE SHIELD