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General NPI Number Information
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NPI Number | 1306902895
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Entity Type | Individual
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Provider Name | BINH CONG NGUYEN D.D.S
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Gender | Male
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10022 IMPERIAL AVE STE. A
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City | GARDEN GROVE
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State | CA
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Zip | 92843-2370
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Country | US
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Telephone | 714-534-6969
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Fax |
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Provider Business Mailing Address
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Address Line | 13042 SIEMON AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92843-2242
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Country | US
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Telephone | 714-588-1067
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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 | 44047
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License Number State | CA
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