Individual
MS. TUYET THI VAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
520 W. PERSHING BLVD., NORTH LITTLE ROCK, AR 72114
(501) 753-2800
(501) 907-6456
Mailing address
520 W. PERSHING BLVD., SUITE C, NORTH LITTLE ROCK, AR 72114
(501) 753-2800
(501) 907-6456
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3774
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184500608
—
AR
Enumeration date
08/05/2010
Last updated
12/06/2011
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