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General NPI Number Information
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NPI Number | 1982722617
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Entity Type | Individual
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Provider Name | ALAN SON NGUYEN DMD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 3009 PHILADELPHIA PIKE
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City | CLAYMONT
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State | DE
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Zip | 19703
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Country | US
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Telephone | 302-793-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 HIGH MEADOW LN
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City | BOOTHWYN
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State | PA
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Zip | 19060-1738
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Country | US
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Telephone | 267-303-7274
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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 | G1-0001295
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02321000
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License Number State | NJ
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