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General NPI Number Information
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NPI Number | 1255721916
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Entity Type | Organization
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Legal Business Name | THIEN C NGUYEN, DDS, A DENTAL CORPORATION
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 2907 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90026-2127
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Country | US
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Telephone | 323-663-2141
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Fax |
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Provider Business Mailing Address
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Address Line | 2907 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90026-2127
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Country | US
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Telephone | 323-663-2141
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | THIEN NGUYEN
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Credential |
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Telephone | 626-378-4564
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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 | 45511
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License Number State | CA
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