Provider Demographics
NPI:1407342322
Name:NGUYEN, CAMHA P
Entity Type:Individual
Prefix:DR
First Name:CAMHA
Middle Name:P
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-3434
Mailing Address - Country:US
Mailing Address - Phone:407-451-5475
Mailing Address - Fax:
Practice Address - Street 1:2619 GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808
Practice Address - Country:US
Practice Address - Phone:407-451-5475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN23444122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist