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NPI Code Detail

MEDICARE: DR. PAUL L NGUYEN

MEDICARE: DR. PAUL L NGUYEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry6027LA

General Provider Information

NPI Number : 1205153954
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL L NGUYEN
Provider Business Mailing Address
First Line : 10526 MANCHAC PASS AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70817-8335
Country : US
Telephone Number : 225-614-1359
Fax Number :
Provider Business Practice Location Address
First Line : 37279 MARKET PLACE DR
Second Line :
City : PRAIRIEVILLE
State : LA
Zip : 70769-3487
Country : US
Telephone Number : 225-673-1647
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2010
Last Update Date : 12/07/2022

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