Provider Demographics
NPI:1326450065
Name:NGUYEN, VICKY H (RDH)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:H
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CORDAGE PARK CIR STE 115
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7318
Mailing Address - Country:US
Mailing Address - Phone:508-778-5470
Mailing Address - Fax:
Practice Address - Street 1:10 CORDAGE PARK CIR STE 115
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7318
Practice Address - Country:US
Practice Address - Phone:508-778-5470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADH13867124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist