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General NPI Number Information
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NPI Number | 1992863211
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Entity Type | Organization
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Legal Business Name | SAN JOSE DENTAL CARE
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 345 E SANTA CLARA ST STE 102
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City | SAN JOSE
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State | CA
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Zip | 95113-1933
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Country | US
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Telephone | 408-998-8866
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Fax | 408-998-8857
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Provider Business Mailing Address
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Address Line | 345 E SANTA CLARA ST STE 102
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City | SAN JOSE
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State | CA
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Zip | 95113-1933
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Country | US
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Telephone | 408-998-8866
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Fax | 408-998-8857
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Authorized Official
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Title or Position | DENTIST
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Name | DR. WILLIAM HUY QUANG NGUYEN
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Credential | DDS
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Telephone | 408-998-8866
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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 | 47538
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License Number State | CA
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