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General NPI Number Information
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NPI Number | 1912191115
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Entity Type | Organization
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Legal Business Name | HIEN AND DIANE NGUYEN DENTAL CORPORATION
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 02/03/2008
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Provider Practice Location Address
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Address Line | 3944 PECK RD STE 2
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City | EL MONTE
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State | CA
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Zip | 91732-2200
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Country | US
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Telephone | 626-401-2445
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Fax |
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Provider Business Mailing Address
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Address Line | 3944 PECK RD STE 2
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City | EL MONTE
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State | CA
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Zip | 91732-2200
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Country | US
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Telephone | 626-401-2445
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HIEN SI NGUYEN
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Credential | DDS
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Telephone | 626-401-2445
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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 | 36185
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License Number State | CA
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