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General NPI Number Information
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NPI Number | 1285137729
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Entity Type | Organization
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Legal Business Name | HOA NGUYEN, DMD, INC
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 03/12/2018
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Provider Practice Location Address
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Address Line | 9190 SIERRA AVE STE 101
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City | FONTANA
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State | CA
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Zip | 92335-8613
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Country | US
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Telephone | 714-474-1758
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Fax |
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Provider Business Mailing Address
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Address Line | 5040 S COULTER ST APT 618
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City | AMARILLO
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State | TX
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Zip | 79119-5424
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Country | US
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Telephone | 714-474-1758
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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. HOA NGUYEN
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Credential | DMD
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Telephone | 714-474-1758
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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 | 64645
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License Number State | CA
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