Individual
THANG NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5665 HIGHWAY 95 N, LAKE HAVASU CITY, AZ 86404-9646
(928) 397-7007
Mailing address
2935 HAVASUPAI BLVD UNIT A102, LAKE HAVASU CITY, AZ 86404-3466
(510) 599-1509
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D012597
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/04/2025
Last updated
07/21/2025
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