1033387501 NPI number — SEMINARY DENTAL CLINIC P. A.

Table of content: DR. BINH VIET VO M.D. (NPI 1235188459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033387501 NPI number — SEMINARY DENTAL CLINIC P. A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SEMINARY DENTAL CLINIC P. A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033387501
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4763 BARWICK DR.
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-926-5485
Provider Business Mailing Address Fax Number:
817-926-5523

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4763 BARWICK DR.
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-926-5485
Provider Business Practice Location Address Fax Number:
817-926-5523
Provider Enumeration Date:
02/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DESAI
Authorized Official First Name:
MITA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
817-926-5485

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  21968 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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