Provider Demographics
NPI:1982855672
Name:NGUYEN, KARI AN (DMD)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:AN
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:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14231-0316
Mailing Address - Country:US
Mailing Address - Phone:716-204-4999
Mailing Address - Fax:716-632-7966
Practice Address - Street 1:930 BOARDMAN POLAND RD
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5117
Practice Address - Country:US
Practice Address - Phone:330-259-0276
Practice Address - Fax:330-758-8690
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.022719122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist