Provider Demographics
NPI:1609068790
Name:TAN, QUYNH-THUYEN NGUYEN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:QUYNH-THUYEN
Middle Name:NGUYEN
Last Name:TAN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19875 SOUTHWEST FREEWAY, STE 250
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:281-937-7633
Mailing Address - Fax:281-937-7643
Practice Address - Street 1:19875 SOUTHWEST FREEWAY, STE 250
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-937-7633
Practice Address - Fax:281-937-7643
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics