Provider Demographics
NPI:1205206679
Name:CHI T. NGUYEN, DDS, PA
Entity Type:Organization
Organization Name:CHI T. NGUYEN, DDS, PA
Other - Org Name:A FAMILY DENTIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAI
Authorized Official - Middle Name:THI
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-642-8885
Mailing Address - Street 1:PO BOX 5340
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33571-5340
Mailing Address - Country:US
Mailing Address - Phone:813-642-8885
Mailing Address - Fax:813-642-8891
Practice Address - Street 1:768 CORTARO DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33573-6811
Practice Address - Country:US
Practice Address - Phone:813-642-8885
Practice Address - Fax:813-642-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty