Provider Demographics
NPI:1003122375
Name:NGUYEN, ANH T (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANH
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2295 CALIFORNIA ST APT 37
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2860
Mailing Address - Country:US
Mailing Address - Phone:408-209-4711
Mailing Address - Fax:
Practice Address - Street 1:2295 CALIFORNIA ST APT 37
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2860
Practice Address - Country:US
Practice Address - Phone:408-209-4711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59672122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist