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General NPI Number Information
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NPI Number | 1073280939
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Entity Type | Individual
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Provider Name | MICHELLE NGUYEN DMD
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Gender | Female
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 105 MYRTLE ST
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City | NEW BRITAIN
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State | CT
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Zip | 06051-1859
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Country | US
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Telephone | 860-801-8650
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Fax |
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Provider Business Mailing Address
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Address Line | 89 PIERCE BLVD
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City | WINDSOR
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State | CT
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Zip | 06095-1791
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Country | US
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Telephone | 860-578-3682
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 12520
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN27651
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14238
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License Number State | CT
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