Provider Demographics
NPI:1114183639
Name:THAO TRANG NGUYEN, DMD, PA
Entity Type:Organization
Organization Name:THAO TRANG NGUYEN, DMD, PA
Other - Org Name:WINNING SMILES FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:TRANG
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-868-2004
Mailing Address - Street 1:7801 OLD BRANCH AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-1608
Mailing Address - Country:US
Mailing Address - Phone:301-868-2004
Mailing Address - Fax:301-868-2025
Practice Address - Street 1:7801 OLD BRANCH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1608
Practice Address - Country:US
Practice Address - Phone:301-868-2004
Practice Address - Fax:301-868-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13638122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty