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General NPI Number Information
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NPI Number | 1770105009
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Entity Type | Individual
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Provider Name | NHAN JAMES HUU NGO DMD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 05/14/2020
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Provider Practice Location Address
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Address Line | 215 UPLAND SQ DR
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City | POTTSTOWN
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State | PA
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Zip | 19464-9427
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Country | US
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Telephone | 610-323-6350
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 PINE ST APT 301
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4949
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Country | US
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Telephone | 215-520-1113
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DS042636
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License Number State | PA
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