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General NPI Number Information
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NPI Number | 1568213221
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Entity Type | Organization
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Legal Business Name | AURORA DENTISTRY, INC
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 118 S PARK VICTORIA DR
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City | MILPITAS
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State | CA
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Zip | 95035-5724
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Country | US
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Telephone | 408-934-9867
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Fax |
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Provider Business Mailing Address
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Address Line | 3846 ASHRIDGE LN
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City | SAN JOSE
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State | CA
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Zip | 95121-1404
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Country | US
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Telephone | 408-784-2248
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KHOA TIEN NGUYEN
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Credential | DMD
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Telephone | 408-784-2248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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