Provider Demographics
NPI:1538407101
Name:XUAN THOU, DDS, PA
Entity type:Organization
Organization Name:XUAN THOU, DDS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:XUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-434-1288
Mailing Address - Street 1:5270 W 84TH ST
Mailing Address - Street 2:STE #360
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-1373
Mailing Address - Country:US
Mailing Address - Phone:651-835-0666
Mailing Address - Fax:
Practice Address - Street 1:5270 W 84TH ST
Practice Address - Street 2:STE #360
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-1373
Practice Address - Country:US
Practice Address - Phone:651-835-0666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental