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General NPI Number Information
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NPI Number | 1861637951
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Entity Type | Organization
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Legal Business Name | PHONG NGUYEN D.D.S. PC
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 9595 JONES RD.
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City | HOUSTON
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State | TX
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Zip | 77065
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Country | US
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Telephone | 281-955-2800
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Fax | 281-955-5353
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Provider Business Mailing Address
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Address Line | 9595 JONES RD
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City | HOUSTON
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State | TX
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Zip | 77065
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Country | US
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Telephone | 281-955-2800
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Fax | 281-955-5353
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHONG THANH NGUYEN
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Credential | DDS
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Telephone | 281-955-2800
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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 | 22398
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 24553
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License Number State | TX
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