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General NPI Number Information
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NPI Number | 1770775041
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Entity Type | Organization
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Legal Business Name | SC DENTAL
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 9741 BOLSA AVE SUITE 106
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City | WESTMINSTER
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State | CA
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Zip | 92683-6683
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Country | US
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Telephone | 714-775-8434
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Fax | 714-775-1241
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Provider Business Mailing Address
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Address Line | 9741 BOLSA AVE SUITE 106
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City | WESTMINSTER
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State | CA
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Zip | 92683-6683
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Country | US
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Telephone | 714-775-8434
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Fax | 714-775-1241
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD TUANHO NGUYEN
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Credential | DDS
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Telephone | 714-775-8434
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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 | 52659
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License Number State | CA
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