Provider Demographics
NPI:1790907376
Name:NGUYEN, DOUG Q (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOUG
Middle Name:Q
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 1:18101 HIGHWOODS PRESERVE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1791
Mailing Address - Country:US
Mailing Address - Phone:813-903-9877
Mailing Address - Fax:813-903-9874
Practice Address - Street 1:18101 HIGHWOODS PRESERVE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1791
Practice Address - Country:US
Practice Address - Phone:813-903-9877
Practice Address - Fax:813-903-9874
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN-13930122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist