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General NPI Number Information
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NPI Number | 1184804684
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Entity Type | Individual
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Provider Name | MICHAEL CUU HUU NGUYEN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 4480 S COBB DR SE STE J
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City | SMYRNA
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State | GA
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Zip | 30080-6984
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Country | US
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Telephone | 678-305-9916
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Fax | 678-305-9867
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Provider Business Mailing Address
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Address Line | 4480 SOUTH COBB DR. SUITE J
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City | SMYRNA
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State | GA
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Zip | 30080
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Country | US
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Telephone | 678-305-9916
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Fax | 678-305-9867
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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 | DN012242
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License Number State | GA
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