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General NPI Number Information
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NPI Number | 1942334685
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Entity Type | Organization
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Legal Business Name | TRACEY NGUYEN DDS,PC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 19450 DEERFIELD AVE STE 485
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City | LANSDOWNE
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State | VA
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Zip | 20176-6820
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Country | US
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Telephone | 703-723-7810
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Fax | 703-723-7812
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Provider Business Mailing Address
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Address Line | 19450 DEERFIELD AVE STE 485
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City | LANSDOWNE
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State | VA
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Zip | 20176-6820
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Country | US
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Telephone | 703-723-7810
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Fax | 703-723-7812
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. PAULA FLOHR
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Credential |
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Telephone | 703-723-7810
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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 | 0401410569
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License Number State | VA
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