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General NPI Number Information
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NPI Number | 1558642835
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Entity Type | Individual
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Provider Name | DUY M NGUYEN DDS
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Gender | Male
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Dates
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Enumeration Date | 08/31/2011
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 55 BILL DRAKE WAY STE B
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City | PACIFICA
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State | CA
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Zip | 94044-1802
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Country | US
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Telephone | 650-735-1608
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Fax | 888-509-8199
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Provider Business Mailing Address
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Address Line | 55 BILL DRAKE WAY STE B
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City | PACIFICA
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State | CA
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Zip | 94044-1802
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Country | US
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Telephone | 650-735-1608
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Fax | 888-509-8199
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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 | 61432
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License Number State | CA
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