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General NPI Number Information
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NPI Number | 1144559972
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Entity Type | Organization
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Legal Business Name | KHOI P NGUYEN,DSS, INC
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 2708 WESTMINSTER AVE # 100
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City | SANTA ANA
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State | CA
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Zip | 92706-2133
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Country | US
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Telephone | 714-554-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 2708 WESTMINSTER AVE # 100
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City | SANTA ANA
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State | CA
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Zip | 92706-2133
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Country | US
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Telephone | 714-554-0700
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KHOI P NGUYEN
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Credential | DDS
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Telephone | 714-554-0700
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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 | 57821
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License Number State | CA
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