Provider Demographics
NPI:1083802003
Name:NGUYEN, QUOC LAP (DDS)
Entity Type:Individual
Prefix:DR
First Name:QUOC
Middle Name:LAP
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24953 PASEO DE VALENCIA
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4342
Mailing Address - Country:US
Mailing Address - Phone:949-768-4071
Mailing Address - Fax:949-768-0292
Practice Address - Street 1:24953 PASEO DE VALENCIA
Practice Address - Street 2:SUITE 1C
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4342
Practice Address - Country:US
Practice Address - Phone:949-768-4071
Practice Address - Fax:949-768-0292
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA593521223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA59352OtherDENTAL BOARD OF CALIFORNIA