Provider Demographics
NPI:1205365921
Name:NGUYEN, ANHTUAN (DMD, MBS, MS)
Entity type:Individual
Prefix:DR
First Name:ANHTUAN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DMD, MBS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2595 CLEVELAND PL
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:FL
Mailing Address - Zip Code:34762-1424
Mailing Address - Country:US
Mailing Address - Phone:407-374-3617
Mailing Address - Fax:
Practice Address - Street 1:4924 COUNTY ROAD 466A STE B
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-3617
Practice Address - Country:US
Practice Address - Phone:352-492-3276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-06
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22662122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist