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General NPI Number Information
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NPI Number | 1932992252
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Entity Type | Individual
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Provider Name | KHANH NGUYEN DOAN DMD
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Gender |
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 761 WESTERN AVE UNIT 23
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City | HAMPDEN
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State | ME
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Zip | 04444-1074
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Country | US
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Telephone | 858-333-2254
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Fax |
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Provider Business Mailing Address
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Address Line | 761 WESTERN AVE UNIT 23
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City | HAMPDEN
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State | ME
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Zip | 04444-1074
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Country | US
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Telephone | 858-333-2254
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN5260
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License Number State | ME
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