Provider Demographics
NPI:1184804684
Name:NGUYEN, MICHAEL CUU HUU (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CUU HUU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:CUU
Other - Middle Name:HUU
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:4480 SOUTH COBB DR. SUITE J
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080
Mailing Address - Country:US
Mailing Address - Phone:678-305-9916
Mailing Address - Fax:678-305-9867
Practice Address - Street 1:4480 S COBB DR SE STE J
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6984
Practice Address - Country:US
Practice Address - Phone:678-305-9916
Practice Address - Fax:678-305-9867
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN012242122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist