Individual
BAO TRUC SYBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4502 CHARLOTTE PIKE, NASHVILLE, TN 37209
(615) 933-1981
Mailing address
1400 ROSA L PARKS BLVD APT 217, NASHVILLE, TN 37208-2571
(504) 723-4028
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11157
TN
122300000X
Dentist
Primary
23587
FL
Other
Enumeration date
05/23/2019
Last updated
09/27/2019
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