Provider Demographics
NPI:1417031600
Name:NGUYEN, DUAT DAC (DDS)
Entity Type:Individual
Prefix:DR
First Name:DUAT
Middle Name:DAC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DUAT
Other - Middle Name:DAC
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:10911 BAMMEL N.HOUSTON
Mailing Address - Street 2:234
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77086
Mailing Address - Country:US
Mailing Address - Phone:281-537-9991
Mailing Address - Fax:281-537-9992
Practice Address - Street 1:10911 BAMMEL N.HOUSTON
Practice Address - Street 2:234
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086
Practice Address - Country:US
Practice Address - Phone:281-537-9991
Practice Address - Fax:281-537-9992
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice