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General NPI Number Information
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NPI Number | 1881954410
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Entity Type | Organization
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Legal Business Name | BRIAN P. NGUYEN, DMD, PLLC ORAL AND MAXILLOFACIAL SURGERY
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | 2628 N MOUNT JULIET RD
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City | MOUNT JULIET
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State | TN
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Zip | 37122-8015
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Country | US
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Telephone | 615-777-1800
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Fax | 615-777-3707
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Provider Business Mailing Address
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Address Line | 2628 N MOUNT JULIET RD
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City | MOUNT JULIET
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State | TN
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Zip | 37122-8015
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Country | US
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Telephone | 615-777-1800
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Fax | 615-777-3707
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Authorized Official
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Title or Position | ORAL SURGEON
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Name | DR. HOANG PHI NGUYEN
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Credential | DMD
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Telephone | 615-777-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS0000009075
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License Number State | TN
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