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General NPI Number Information
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NPI Number | 1164615027
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Entity Type | Organization
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Legal Business Name | DU HUU NGUYEN,D.D.S.,INC.
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 1305 W ARROW HWY SUITE 101
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City | SAN DIMAS
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State | CA
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Zip | 91773-2336
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Country | US
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Telephone | 909-599-8855
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Fax | 909-599-5333
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Provider Business Mailing Address
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Address Line | 1305 W ARROW HWY SUITE 101
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City | SAN DIMAS
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State | CA
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Zip | 91773-2336
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Country | US
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Telephone | 909-599-8855
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Fax | 909-599-5333
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Authorized Official
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Title or Position | DENTIST/PRESIDENT
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Name | DR. DU HUU NGUYEN
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Credential | D.D.S.
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Telephone | 909-599-8855
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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 | 49165
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License Number State | CA
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