Provider Demographics
NPI:1578781548
Name:NGUYEN, TOAN DUY (DDS)
Entity Type:Individual
Prefix:DR
First Name:TOAN
Middle Name:DUY
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 N SAN DIMAS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-2649
Mailing Address - Country:US
Mailing Address - Phone:909-599-3398
Mailing Address - Fax:909-599-1398
Practice Address - Street 1:213 N SAN DIMAS AVE
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-2649
Practice Address - Country:US
Practice Address - Phone:909-599-3398
Practice Address - Fax:909-599-1398
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA453021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice