Provider Demographics
NPI:1437585544
Name:DAN TIEN NGUYEN, DDS, APC
Entity Type:Organization
Organization Name:DAN TIEN NGUYEN, DDS, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THAO
Authorized Official - Middle Name:THI
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-804-9807
Mailing Address - Street 1:55 W SIERRA MADRE BLVD STE 215
Mailing Address - Street 2:
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-3017
Mailing Address - Country:US
Mailing Address - Phone:626-355-2391
Mailing Address - Fax:
Practice Address - Street 1:55 W SIERRA MADRE BLVD STE 215
Practice Address - Street 2:
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024-3017
Practice Address - Country:US
Practice Address - Phone:626-355-2391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty