Provider Demographics
NPI:1992768055
Name:TRIEU, CAROLYN MAI (DMD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:MAI
Last Name:TRIEU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:CAROLYN
Other - Middle Name:MAI
Other - Last Name:TRIEU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:2223 SINGLETON BLVD.
Mailing Address - Street 2:SUITE 212
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75212
Mailing Address - Country:US
Mailing Address - Phone:214-678-9200
Mailing Address - Fax:
Practice Address - Street 1:2223 SINGLETON BLVD
Practice Address - Street 2:DALLAS
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75212-3783
Practice Address - Country:US
Practice Address - Phone:214-678-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice