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General NPI Number Information
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NPI Number | 1912525478
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Entity Type | Individual
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Provider Name | QUYNH NGAN NGOC DO DDS
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Gender | Female
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Dates
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Enumeration Date | 07/10/2020
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 2240 E. WINROW AVE US ARMY DENTAL COMMAND
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City | FORT HUACHUCA
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State | AZ
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Zip | 85613-5080
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Country | US
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Telephone | 404-250-2383
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 WINROW RD BLDG 45005
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City | FORT HUACHUCA
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State | AZ
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Zip | 85613-5080
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Country | US
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Telephone | 520-533-9200
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019032786
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019032786
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License Number State | IL
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