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General NPI Number Information
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NPI Number | 1275227423
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Entity Type | Organization
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Legal Business Name | AN NGUYEN DMD INC
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 7056 ARCHIBALD AVE STE 105
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City | EASTVALE
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State | CA
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Zip | 92880-8714
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Country | US
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Telephone | 951-407-1119
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Fax |
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Provider Business Mailing Address
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Address Line | 3366 GINGHAM CT
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City | CHINO HILLS
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State | CA
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Zip | 91709-2811
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Country | US
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Telephone | 909-217-8137
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AN D NGUYEN
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Credential | DMD
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Telephone | 909-217-8137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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