Individual
THAIDA DUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
532 SUMNER AVE, SPRINGFIELD, MA 01108-2458
(413) 739-1100
(413) 737-3608
Mailing address
532 SUMNER AVE, SPRINGFIELD, MA 01108-2458
(413) 739-1100
(413) 737-3608
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1855116
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1310097
—
MA
Enumeration date
07/06/2009
Last updated
07/06/2009
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