Provider Demographics
NPI:1902936495
Name:VU, GWENDOLYN TU (DMD)
Entity Type:Individual
Prefix:DR
First Name:GWENDOLYN
Middle Name:TU
Last Name:VU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 S MAYS ST
Mailing Address - Street 2:STE E
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-6740
Mailing Address - Country:US
Mailing Address - Phone:512-248-8888
Mailing Address - Fax:
Practice Address - Street 1:1715 S MAYS ST
Practice Address - Street 2:STE E
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-6740
Practice Address - Country:US
Practice Address - Phone:512-248-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice