MEDICARE: DR. CHRISTINE BICH-VAN HOANG NGUYEN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN15461	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DN15461	OTHER	FL	FLORIDA DENTAL LICENSE

General Provider Information

NPI Number	:	1306988050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE BICH-VAN HOANG NGUYEN D.D.S.

Provider Business Mailing Address
First Line	:	1330 S ORLANDO AVE
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-5560
Country	:	US
Telephone Number	:	407-629-4077
Fax Number	:	407-629-4431

Provider Business Practice Location Address
First Line	:	1330 S ORLANDO AVE
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-5560
Country	:	US
Telephone Number	:	407-629-4077
Fax Number	:	407-629-4431

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	04/09/2012

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