Provider Demographics
NPI:1750486726
Name:NGUYEN, ANTHONY TUAN (DDS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:TUAN
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 1:969 WINDY HILL RD SE
Mailing Address - Street 2:SUITE G
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-2003
Mailing Address - Country:US
Mailing Address - Phone:770-438-6993
Mailing Address - Fax:770-438-2919
Practice Address - Street 1:969 WINDY HILL RD SE
Practice Address - Street 2:SUITE G
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-2003
Practice Address - Country:US
Practice Address - Phone:770-438-6993
Practice Address - Fax:770-438-2919
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0121531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GABN6715114OtherDEA