Individual
LAN NGOC VU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
826 W PORTER ST, PHILADELPHIA, PA 19148-3744
(215) 336-8391
Mailing address
4247 LOCUST ST APT 418, PHILADELPHIA, PA 19104-5265
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS039338
PA
Other
Enumeration date
09/13/2012
Last updated
05/13/2013
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