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General NPI Number Information
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NPI Number | 1821460221
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Entity Type | Organization
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Legal Business Name | FLOSS AND GLOSS DENTAL
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Dates
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Enumeration Date | 10/24/2015
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Last Update Date | 10/24/2015
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Provider Practice Location Address
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Address Line | 10542 MCFADDEN AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92843-5352
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Country | US
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Telephone | 714-531-4531
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Fax | 714-531-4533
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Provider Business Mailing Address
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Address Line | 10542 MCFADDEN AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92843-5352
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Country | US
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Telephone | 714-531-4531
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Fax | 714-531-4533
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Authorized Official
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Title or Position | CEO
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Name | DR. THUY THI NGUYEN
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Credential | DDS
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Telephone | 714-531-4531
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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 | 51115
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License Number State | CA
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