Provider Demographics
NPI:1487841441
Name:NGUYEN, TRUC NHU (RDHAP)
Entity Type:Individual
Prefix:MISS
First Name:TRUC
Middle Name:NHU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4057 BRANT ST.
Mailing Address - Street 2:APT. #4
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1991
Mailing Address - Country:US
Mailing Address - Phone:858-204-2071
Mailing Address - Fax:
Practice Address - Street 1:4057 BRANT ST.
Practice Address - Street 2:APT. #4
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1991
Practice Address - Country:US
Practice Address - Phone:858-204-2071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA185124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist