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NPI Code Detail

MEDICARE: DAT NGUYEN D.D.S.

MEDICARE:   DAT  NGUYEN  D.D.S.
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 Dentistry54670CA

General Provider Information

NPI Number : 1770708943
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAT NGUYEN D.D.S.
Provider Business Mailing Address
First Line : 11251 FRANKMONT CT
Second Line :
City : EL MONTE
State : CA
Zip : 91732-2152
Country : US
Telephone Number : 626-448-2198
Fax Number :
Provider Business Practice Location Address
First Line : 12072 VALLEY BLVD
Second Line :
City : EL MONTE
State : CA
Zip : 91732-3137
Country : US
Telephone Number : 626-527-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2007
Last Update Date : 07/08/2007

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Directions to “ DAT NGUYEN D.D.S.” Practice Location

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