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General NPI Number Information
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NPI Number | 1710601257
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Entity Type | Organization
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Legal Business Name | DAVID & LINH NGUYEN, D.D.S. A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 8805 ELK GROVE BLVD STE B
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City | ELK GROVE
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State | CA
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Zip | 95624-1877
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Country | US
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Telephone | 916-691-2226
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Fax |
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Provider Business Mailing Address
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Address Line | 525 S FAIRMONT AVE STE G
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City | LODI
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State | CA
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Zip | 95240-3860
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE
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Name | LINH NGUYEN
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Credential | D.D.S.
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Telephone | 916-897-7188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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