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General NPI Number Information
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NPI Number | 1730300724
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Entity Type | Organization
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Legal Business Name | THAI NGUYEN DDS, INC
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10 SOUTH HILLVIEW
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City | MILPITAS
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State | CA
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Zip | 95035
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Country | US
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Telephone | 510-685-0687
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Fax | 408-929-7999
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Provider Business Mailing Address
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Address Line | 2491 CLEAR SPRING CT
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City | SAN JOSE
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State | CA
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Zip | 95133
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Country | US
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Telephone | 510-685-0687
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Fax | 408-929-7999
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THAI HUU NEUYEN
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Credential | DDS
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Telephone | 510-685-0687
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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 | 50332
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License Number State | CA
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