Provider Demographics
NPI:1083700850
Name:NGUYEN, NGOCTRINH (DDS)
Entity Type:Individual
Prefix:DR
First Name:NGOCTRINH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-5951
Mailing Address - Country:US
Mailing Address - Phone:831-678-0881
Mailing Address - Fax:
Practice Address - Street 1:799 FRONT ST
Practice Address - Street 2:
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93960-3017
Practice Address - Country:US
Practice Address - Phone:831-678-0881
Practice Address - Fax:831-678-2803
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51365122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist