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General NPI Number Information
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NPI Number | 1023229747
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Entity Type | Organization
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Legal Business Name | CHIC DENTAL CARE
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/08/2011
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Provider Practice Location Address
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Address Line | 5278 MONTEREY HWY SUITE 10
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City | SAN JOSE
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State | CA
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Zip | 95111-4268
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Country | US
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Telephone | 408-362-9622
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Fax | 408-362-9633
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Provider Business Mailing Address
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Address Line | 5278 MONTEREY HWY SUITE 10
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City | SAN JOSE
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State | CA
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Zip | 95111-4268
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Country | US
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Telephone | 408-362-9622
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Fax | 408-362-9633
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAULINE PHUONG NGUYEN
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Credential | DDS
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Telephone | 408-362-9622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 47143
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License Number State | CA
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