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General NPI Number Information
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NPI Number | 1245958149
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Entity Type | Individual
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Provider Name | PATRICK LONGDUY NGUYEN DDS
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Gender | Male
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Dates
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Enumeration Date | 08/16/2022
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 12125 HIGHWAY 6 STE D
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City | FRESNO
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State | TX
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Zip | 77545-8844
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Country | US
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Telephone | 281-431-8909
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Fax |
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Provider Business Mailing Address
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Address Line | 815 S FLOWER ST APT 2
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City | INGLEWOOD
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State | CA
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Zip | 90301-5385
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Country | US
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Telephone | 310-256-6361
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 38875
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License Number State | TX
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