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General NPI Number Information
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NPI Number | 1144813510
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Entity Type | Organization
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Legal Business Name | NICK NGUYEN DDS LLC
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Dates
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Enumeration Date | 02/17/2021
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 55 FREEDOM PKWY STE 104
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City | HOSCHTON
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State | GA
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Zip | 30548-1996
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Country | US
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Telephone | 706-658-2383
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Fax |
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Provider Business Mailing Address
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Address Line | 1016 WOLF RUN CT
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-6601
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Country | US
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Telephone | 470-232-3168
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DUC TRUNG TRUNG NGUYEN
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Credential | DDS
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Telephone | 706-658-2383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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