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General NPI Number Information
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NPI Number | 1649424532
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Entity Type | Organization
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Legal Business Name | JASON NGUYEN'S DENTAL CORPORATION
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 6300 WHITE LN STE C
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City | BAKERSFIELD
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State | CA
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Zip | 93309-8776
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Country | US
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Telephone | 661-827-1100
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Fax | 661-827-1117
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Provider Business Mailing Address
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Address Line | 6300 WHITE LN STE C
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City | BAKERSFIELD
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State | CA
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Zip | 93309-8776
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Country | US
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Telephone | 661-827-1100
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Fax | 661-827-1117
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JASON KHOA NGUYEN
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Credential | DDS
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Telephone | 661-827-1100
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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 | 53634
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License Number State | CA
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