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General NPI Number Information
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NPI Number | 1700314317
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Entity Type | Individual
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Provider Name | LYNN MY NGUYEN DDS
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Gender | Female
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Dates
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Enumeration Date | 05/25/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 2620 NW EXPRESSWAY STE E
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-7207
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Country | US
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Telephone | 405-943-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 2220 SW 33RD ST
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City | MOORE
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State | OK
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Zip | 73170-4542
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Country | US
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Telephone | 505-204-5677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6299
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License Number State | OK
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