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General NPI Number Information
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NPI Number | 1023339736
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Entity Type | Organization
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Legal Business Name | NGUYEN & TRUONG DENTAL CORP
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 06/16/2010
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Provider Practice Location Address
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Address Line | 12385 CENTRAL AVE UNIT # A
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City | CHINO
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State | CA
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Zip | 91710-2624
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Country | US
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Telephone | 909-628-4141
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Fax | 909-628-4121
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Provider Business Mailing Address
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Address Line | 12385 CENTRAL AVE UNIT # A
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City | CHINO
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State | CA
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Zip | 91710-2624
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Country | US
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Telephone | 909-628-4141
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Fax | 909-628-4121
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. TIFFANY TRUONG
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Credential | DDS
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Telephone | 951-642-1536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 47968
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 46538
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License Number State | CA
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