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General NPI Number Information
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NPI Number | 1386589067
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Entity Type | Organization
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Legal Business Name | MARIETTA DENTIST
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 278 N MARIETTA PKWY NE
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City | MARIETTA
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State | GA
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Zip | 30060-1456
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Country | US
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Telephone | 770-565-0764
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Fax |
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Provider Business Mailing Address
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Address Line | 278 N MARIETTA PKWY NE
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City | MARIETTA
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State | GA
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Zip | 30060-1456
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DANNY NGUYEN
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Credential | DMD
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Telephone | 925-457-6881
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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 |
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License Number State |
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