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General NPI Number Information
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NPI Number | 1699848564
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Entity Type | Organization
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Legal Business Name | HOANG MAXX MINH NGUYEN, DDS, A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 12/05/2014
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Provider Practice Location Address
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Address Line | 351 COURT STREET
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City | WOODLAND
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State | CA
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Zip | 95695
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Country | US
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Telephone | 530-666-3657
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Fax | 530-666-1601
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Provider Business Mailing Address
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Address Line | 351 COURT STREET
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City | WOODLAND
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State | CA
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Zip | 95695
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Country | US
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Telephone | 530-666-3657
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Fax | 530-666-1601
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HOANG MAXX MINH NGUYEN
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Credential | DDS
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Telephone | 530-666-3657
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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 | 50169
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License Number State | CA
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