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NPI Code Detail

MEDICARE: DR. DEAN VAN NGUYEN DDS

MEDICARE:  DR. DEAN VAN NGUYEN  DDS
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
11223G0001XGeneral Practice Dentistry50797CA

General Provider Information

NPI Number : 1396962023
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEAN VAN NGUYEN DDS
Provider Business Mailing Address
First Line : 4082 30TH ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92104-2602
Country : US
Telephone Number : 619-283-6381
Fax Number : 619-528-0974
Provider Business Practice Location Address
First Line : 4082 30TH ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92104-2602
Country : US
Telephone Number : 619-283-6381
Fax Number : 619-528-0974
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2007
Last Update Date : 10/24/2011

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Directions to “ DR. DEAN VAN NGUYEN DDS” Practice Location

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