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General NPI Number Information
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NPI Number | 1891059051
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Entity Type | Organization
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Legal Business Name | GENTLE TOUCH DENTAL PC
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 400 S MAPLE AVE SUITE 103
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City | FALLS CHURCH
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State | VA
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Zip | 22046-4241
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Country | US
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Telephone | 703-752-4253
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Fax | 703-752-4258
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Provider Business Mailing Address
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Address Line | 400 S MAPLE AVE SUITE 103
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City | FALLS CHURCH
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State | VA
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Zip | 22046-4241
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Country | US
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Telephone | 703-752-4253
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Fax | 703-752-4258
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Authorized Official
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Title or Position | DENTIST
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Name | DR. VU NGUYEN
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Credential | D.D.S
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Telephone | 703-752-4253
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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 | 0401410920
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License Number State | VA
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