Individual
HUONG T VU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4745 STATESMEN DR STE E, INDIANAPOLIS, IN 46250
(317) 643-7117
(317) 643-7112
Mailing address
4745 STATESMEN DR STE E, INDIANAPOLIS, IN 46250-5649
(317) 643-7117
(317) 643-7112
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12011252A
IN
1223G0001X
General Practice Dentistry
Primary
12011252A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12011252A
IN DENTAL LICENSE
IN
Enumeration date
12/18/2008
Last updated
09/27/2018
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