Provider Demographics
NPI:1821460221
Name:FLOSS AND GLOSS DENTAL
Entity Type:Organization
Organization Name:FLOSS AND GLOSS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THUY
Authorized Official - Middle Name:THI
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-531-4531
Mailing Address - Street 1:10542 MCFADDEN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-5352
Mailing Address - Country:US
Mailing Address - Phone:714-531-4531
Mailing Address - Fax:714-531-4533
Practice Address - Street 1:10542 MCFADDEN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-5352
Practice Address - Country:US
Practice Address - Phone:714-531-4531
Practice Address - Fax:714-531-4533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-24
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51115122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty