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General NPI Number Information
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NPI Number | 1780346858
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Entity Type | Organization
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Legal Business Name | SUZIE NGUYEN-SU, DDS., LTD
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Dates
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Enumeration Date | 10/06/2021
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Last Update Date | 10/06/2021
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Provider Practice Location Address
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Address Line | 2451 PROFESSIONAL CT STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89128-0827
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Country | US
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Telephone | 702-240-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 2451 PROFESSIONAL CT STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89128-0827
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Country | US
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Telephone | 702-240-4242
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUZIE NGUYEN-SU
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Credential |
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Telephone | 702-480-5777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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