Provider Demographics
NPI:1912119306
Name:VINCENT DO DDS INC
Entity Type:Organization
Organization Name:VINCENT DO DDS INC
Other - Org Name:VINCENT DO DDS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-435-8100
Mailing Address - Street 1:324 E ANAHEIM ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3209
Mailing Address - Country:US
Mailing Address - Phone:562-435-8100
Mailing Address - Fax:
Practice Address - Street 1:324 E ANAHEIM ST
Practice Address - Street 2:SUITE C
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3209
Practice Address - Country:US
Practice Address - Phone:562-435-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization