MEDICARE: HUYEN-NGA NU TON DDS,INC

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	58154	CA

General Provider Information

NPI Number	:	1871944439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUYEN-NGA NU TON DDS,INC

Provider Business Mailing Address
First Line	:	14170 BROOKHURST ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-4658
Country	:	US
Telephone Number	:	714-591-5830
Fax Number	:

Provider Business Practice Location Address
First Line	:	14170 BROOKHURST ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-4658
Country	:	US
Telephone Number	:	714-591-5830
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HUYEN-NGA NU TON
Credential	:	DDS
Telephone Number	:	714-262-0262

Provider Enumeration Date	:	06/24/2016
Last Update Date	:	06/24/2016

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