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General NPI Number Information
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NPI Number | 1679771653
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Entity Type | Organization
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Legal Business Name | NATHAN N.T. NGUYEN DMD INC
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 707 W VALLEY BLVD STE 23
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City | ALHAMBRA
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State | CA
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Zip | 91803-3258
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Country | US
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Telephone | 626-299-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 707 W VALLEY BLVD STE 23
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City | ALHAMBRA
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State | CA
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Zip | 91803-3258
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Country | US
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Telephone | 626-299-1900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT DENTIST
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Name | DR. NATHAN NGUYEN T NGUYEN
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Credential |
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Telephone | 626-299-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 34530
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License Number State | CA
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