Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | 25726 | TX |
Y | 208200000X | Surgeon | R2779 | TX |
Y | 208600000X | Surgeon | R2779 | TX |
NPI | 1467587089 |
---|---|
Provider Name | Dr. David Dai Vu |
First Address | Dallas, TX 75235-6916 |
Second Address | Dallas, TX 75208-2394 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 12/12/2021 |