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General NPI Number Information
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NPI Number | 1558594903
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Entity Type | Individual
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Provider Name | RYAN TRAN ANH NGUYEN DMD
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Gender | Male
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Dates
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Enumeration Date | 09/02/2009
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Last Update Date | 04/05/2013
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Provider Practice Location Address
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Address Line | 7602 N JUPITER RD SUITE 113
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City | GARLAND
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State | TX
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Zip | 75044-2069
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Country | US
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Telephone | 972-530-0893
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Fax | 972-530-0917
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Provider Business Mailing Address
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Address Line | 11921 FOXWOOD LN
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City | FRISCO
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State | TX
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Zip | 75035-0029
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Country | US
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Telephone | 214-263-8633
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Fax | 972-530-0917
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 24966
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License Number State | TX
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