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General NPI Number Information
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NPI Number | 1871512129
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Entity Type | Individual
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Provider Name | HUNG Q NGUYEN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 11/05/2015
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Provider Practice Location Address
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Address Line | 875 N GREENFIELD RD SUITE 111
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City | GILBERT
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State | AZ
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Zip | 85234-5044
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Country | US
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Telephone | 480-558-1988
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Fax | 480-558-9188
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Provider Business Mailing Address
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Address Line | 255 S. DOBSON RD SUITE 3
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City | CHANDLER
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State | AZ
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Zip | 85224
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Country | US
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Telephone | 480-722-1149
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | D 4917
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License Number State | AZ
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