Provider Demographics
NPI:1831303759
Name:NGUYEN, PHUC-HAU BICH (DMD)
Entity Type:Individual
Prefix:DR
First Name:PHUC-HAU
Middle Name:BICH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 NW 64TH LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-8870
Mailing Address - Country:US
Mailing Address - Phone:352-359-1716
Mailing Address - Fax:
Practice Address - Street 1:3661 NW 64TH LN
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-8870
Practice Address - Country:US
Practice Address - Phone:352-359-1716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN167961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice