Provider Demographics
NPI:1811705866
Name:TDH DENTAL PLLC
Entity type:Organization
Organization Name:TDH DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THUAN-VU
Authorized Official - Middle Name:DINH
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:650-283-5130
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-0173
Mailing Address - Country:US
Mailing Address - Phone:650-283-5130
Mailing Address - Fax:
Practice Address - Street 1:5959 SHALLOWFORD RD STE 539
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2240
Practice Address - Country:US
Practice Address - Phone:423-499-8007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty