MEDICARE: DAN NGUYEN DMD

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	122300000X	Dentist	DN17776	FL
2	122300000X	Dentist	25084	TX

General Provider Information

NPI Number	:	1528121332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAN NGUYEN DMD

Provider Business Mailing Address
First Line	:	6415 BABCOCK RD
Second Line	:	SUITE 105
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2980
Country	:	US
Telephone Number	:	210-696-8050
Fax Number	:

Provider Business Practice Location Address
First Line	:	6415 BABCOCK RD STE 105
Second Line	:	SUITE 1
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2963
Country	:	US
Telephone Number	:	210-696-8050
Fax Number	:	210-696-2018

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	09/05/2016

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Directions to “ DAN NGUYEN DMD” Practice Location

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