Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 019.028605 | IL |
NPI | 1346534740 |
---|---|
Provider Name | Dr. Albert Vo |
First Address | Chicago, IL 60646-1510 |
Second Address | Chicago, IL 60617-4225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2011 |
Last Update Date | 06/04/2012 |