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NPI 1528091279

NPI 1528091279 : NHA TRUNG DUONG D.D.S. : OKLAHOMA CITY, OK

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General NPI Number Information
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    NPI Number           |    1528091279
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    Entity Type          |    Individual 
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    Provider Name        |    NHA TRUNG DUONG D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/08/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2836 NW 23RD ST 
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    City                 |    OKLAHOMA CITY
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    State                |    OK
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    Zip                  |    73107-2214
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    Country              |    US
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    Telephone            |    405-943-9010
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    Fax                  |    405-943-9280
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Provider Business Mailing Address
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    Address Line         |    2836 NW 23RD ST 
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    City                 |    OKLAHOMA CITY
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    State                |    OK
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    Zip                  |    73107-2214
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    Country              |    US
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    Telephone            |    405-943-9010
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    Fax                  |    405-943-9280
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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       |    55638
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    License Number State |    OK
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