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General NPI Number Information
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NPI Number | 1861857724
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Entity Type | Organization
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Legal Business Name | A HAPPY SMILE DENTAL OFFICE, PC
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Dates
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Enumeration Date | 12/20/2015
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Last Update Date | 12/20/2015
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Provider Practice Location Address
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Address Line | 33054 STATE ROUTE 26
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City | CARTHAGE
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State | NY
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Zip | 13619-8600
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Country | US
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Telephone | 315-493-9393
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Fax | 315-493-9394
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Provider Business Mailing Address
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Address Line | 33054 STATE ROUTE 26
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City | CARTHAGE
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State | NY
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Zip | 13619-8600
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Country | US
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Telephone | 315-493-9393
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Fax | 315-493-9394
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW THANH NGUYEN
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Credential | D.D.S.
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Telephone | 315-493-9393
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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 | 052642
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License Number State | NY
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