Provider Demographics
NPI:1184840167
Name:NGUYEN, CAMTU THI (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAMTU
Middle Name:THI
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 1:967 MCLAUGHLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-2612
Mailing Address - Country:US
Mailing Address - Phone:408-971-3600
Mailing Address - Fax:408-971-3666
Practice Address - Street 1:967 MCLAUGHLIN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-2612
Practice Address - Country:US
Practice Address - Phone:408-971-3600
Practice Address - Fax:408-971-3666
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA410281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice