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General NPI Number Information
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NPI Number | 1437585544
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Entity Type | Organization
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Legal Business Name | DAN TIEN NGUYEN, DDS, APC
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Dates
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Enumeration Date | 09/20/2013
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Last Update Date | 09/20/2013
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Provider Practice Location Address
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Address Line | 55 W SIERRA MADRE BLVD STE 215
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City | SIERRA MADRE
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State | CA
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Zip | 91024-3017
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Country | US
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Telephone | 626-355-2391
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Fax |
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Provider Business Mailing Address
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Address Line | 55 W SIERRA MADRE BLVD STE 215
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City | SIERRA MADRE
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State | CA
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Zip | 91024-3017
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Country | US
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Telephone | 626-355-2391
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. THAO THI DANG
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Credential |
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Telephone | 213-804-9807
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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 |
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License Number State |
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