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General NPI Number Information
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NPI Number | 1508198615
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Entity Type | Organization
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Legal Business Name | NGUYEN & DO DENTAL CORP
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 15775 IMPERIAL HWY
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City | LA MIRADA
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State | CA
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Zip | 90638-2510
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Country | US
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Telephone | 562-943-4488
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Fax | 562-943-4422
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Provider Business Mailing Address
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Address Line | 15775 IMPERIAL HWY
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City | LA MIRADA
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State | CA
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Zip | 90638-2510
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Country | US
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Telephone | 562-943-4488
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Fax | 562-943-4422
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. DAN CONG NGUYEN
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Credential | D.D.S
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Telephone | 562-943-4488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 46308
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License Number State | CA
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