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General NPI Number Information
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NPI Number | 1265503940
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Entity Type | Organization
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Legal Business Name | VICKY NGUYEN DDS PC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 969 WINDY HILL ROAD 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 | 770-431-9578
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Fax | 770-438-2919
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Provider Business Mailing Address
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Address Line | 969 WINDY HILL ROAD 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 | 770-431-9578
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Fax | 770-438-2919
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Authorized Official
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Title or Position | PRESIDENT DENTIST
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Name | VICKY NGUYEN
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Credential | DDS
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Telephone | 770-431-9578
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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 | 44962
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN011814
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License Number State | GA
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