MEDICARE: DIEP HONG NGUYEN D.M.D.

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
1	122300000X	Dentist	DN17705	FL

General Provider Information

NPI Number	:	1447431861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIEP HONG NGUYEN D.M.D.

Provider Business Mailing Address
First Line	:	6800 SW 71ST CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-3040
Country	:	US
Telephone Number	:	352-514-3894
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 SW 71ST CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-3040
Country	:	US
Telephone Number	:	352-514-3894
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2007
Last Update Date	:	11/14/2007

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