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General NPI Number Information
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NPI Number | 1831732965
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Entity Type | Organization
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Legal Business Name | TAN NGUYEN DDS, INC
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 6 STATE RD
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City | DANVERS
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State | MA
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Zip | 01923-2567
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Country | US
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Telephone | 978-774-6855
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Fax |
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Provider Business Mailing Address
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Address Line | 6 STATE RD
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City | DANVERS
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State | MA
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Zip | 01923-2567
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Country | US
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Telephone | 978-774-6855
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAN NGUYEN
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Credential | DDS, DMSC
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Telephone | 817-707-7467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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