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General NPI Number Information
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NPI Number | 1689074734
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Entity Type | Organization
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Legal Business Name | SON NGUYEN D.D.S., INC.
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Dates
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Enumeration Date | 08/26/2014
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Last Update Date | 03/12/2021
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Provider Practice Location Address
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Address Line | 730 E VALLEY BLVD.
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City | SAN GABRIEL
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State | CA
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Zip | 91776
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Country | US
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Telephone | 626-286-5600
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Fax | 626-286-5605
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Provider Business Mailing Address
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Address Line | 730 E. VALLEY BLVD.
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City | SAN GABRIEL
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State | CA
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Zip | 91776
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Country | US
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Telephone | 626-286-5600
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Fax | 626-286-5605
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Authorized Official
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Title or Position | C.E.O./OWNER
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Name | SON VAN NGUYEN
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Credential | D.D.S.
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Telephone | 714-379-2560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 43049
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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