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General NPI Number Information
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NPI Number | 1497870067
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Entity Type | Organization
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Legal Business Name | PETER B. NGUYEN, DDS, INC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 250 S PACIFIC ST SUITE #100
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City | SAN MARCOS
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State | CA
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Zip | 92078-2476
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Country | US
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Telephone | 760-597-9999
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Fax | 760-798-7960
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Provider Business Mailing Address
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Address Line | 250 S PACIFIC ST SUITE #100
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City | SAN MARCOS
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State | CA
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Zip | 92078-2476
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Country | US
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Telephone | 760-597-9999
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Fax | 760-798-7960
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Authorized Official
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Title or Position | DENTIST
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Name | DR. PETER BA DUC NGUYEN
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Credential | DDS
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Telephone | 760-597-9999
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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 | 47536
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License Number State | CA
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