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General NPI Number Information
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NPI Number | 1821125634
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Entity Type | Individual
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Provider Name | QUYNH C NGUYEN D.D.S
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 10/18/2011
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Provider Practice Location Address
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Address Line | 2395 MONTPELIER DR STE 1
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City | SAN JOSE
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State | CA
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Zip | 95116-1619
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Country | US
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Telephone | 408-272-2888
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Fax | 408-272-5888
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Provider Business Mailing Address
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Address Line | 3766 VINDARA LN
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City | SAN RAMON
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State | CA
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Zip | 94582-5711
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Country | US
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Telephone | 925-803-7577
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 47976
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License Number State | CA
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