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General NPI Number Information
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NPI Number | 1205365921
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Entity Type | Individual
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Provider Name | ANHTUAN NGUYEN DMD, MBS, MS
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Gender | Male
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 4924 COUNTY ROAD 466A STE B
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City | WILDWOOD
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State | FL
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Zip | 34785-3617
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Country | US
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Telephone | 352-492-3276
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Fax |
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Provider Business Mailing Address
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Address Line | 2595 CLEVELAND PL
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City | MIDDLETON
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State | FL
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Zip | 34762-1424
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Country | US
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Telephone | 407-374-3617
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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 | 22662
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License Number State | FL
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