Provider Demographics
NPI:1861638454
Name:NGUYEN, NHAT MINH (DDS)
Entity Type:Individual
Prefix:DR
First Name:NHAT
Middle Name:MINH
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 1:741 SECAUCUS RD
Mailing Address - Street 2:EASTCOAST FAMILY DENTISTRY
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-2565
Mailing Address - Country:US
Mailing Address - Phone:201-963-7898
Mailing Address - Fax:201-963-8781
Practice Address - Street 1:741 SECAUCUS RD
Practice Address - Street 2:EASTCOAST FAMILY DENTISTRY
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2565
Practice Address - Country:US
Practice Address - Phone:201-963-7898
Practice Address - Fax:201-963-8781
Is Sole Proprietor?:No
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02013300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist