Individual
DR. THU THANH TRUONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
412 HALE AVENUE, NEWMAN GROVE, NE 68758-0045
(402) 447-6469
(402) 447-6098
Mailing address
P.O. BOX 45, 412 HALE AVENUE, NEWMAN GROVE, NE 68758-0045
(402) 447-6469
(402) 447-6098
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
37614
CA
122300000X
Dentist
Primary
5593
NE
122300000X
Dentist
M900
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68-0521566-00
—
NE
05
—
68-0521566-01
—
NE
Enumeration date
03/20/2012
Last updated
03/20/2012
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