MEDICARE: TUSCANO DENTAL

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	261QD0000X	Dental Clinic/Center	5995	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942410741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TUSCANO DENTAL

Provider Business Mailing Address
First Line	:	4017 N. 75TH AVE,
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033
Country	:	US
Telephone Number	:	623-907-9334
Fax Number	:	623-474-2876

Provider Business Practice Location Address
First Line	:	4017 N. 75TH AVE,
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033
Country	:	US
Telephone Number	:	623-907-9334
Fax Number	:	623-474-2876

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. PETER PHUOC NGUYEN
Credential	:	DMD
Telephone Number	:	623-907-9334

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	04/08/2023

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Directions to “TUSCANO DENTAL ” Practice Location

Language	Start Address	Practice Location

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