| NPI | 1871942656 |
|---|---|
| Former Name | MACY MAI PHUONG LUONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NM DD4662) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 100466) |
| 1223G0001X Dentist General Practice (Licence: PA DS040871) | |
| Enumeration Date | 2016-06-12 |
| Last Update Date | 2018-03-17 |