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General NPI Number Information
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NPI Number | 1740606706
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Entity Type | Organization
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Legal Business Name | YEN T NGUYEN DMD PLLC
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Dates
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Enumeration Date | 03/13/2014
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Last Update Date | 03/13/2014
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Provider Practice Location Address
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Address Line | 2375 BREWER ROAD
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City | WINSTON-SALEM
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State | NC
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Zip | 27127
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Country | US
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Telephone | 336-245-2690
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Fax | 336-245-2691
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Provider Business Mailing Address
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Address Line | 2375 BREWER ROAD
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City | WINSTON-SALEM
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State | NC
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Zip | 27127
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Country | US
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Telephone | 336-245-2690
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Fax | 336-245-2691
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Authorized Official
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Title or Position | SHAREHOLDER
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Name | YEN T NGUYEN
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Credential | DMD
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Telephone | 336-245-2690
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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 |
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License Number State |
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