Provider Demographics
NPI:1356959522
Name:NGUYEN, ROSY HONG NHUNG
Entity type:Individual
Prefix:
First Name:ROSY HONG NHUNG
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3429 LAWRENCEVILLE SUWANEE RD STE E-F
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2433
Mailing Address - Country:US
Mailing Address - Phone:678-400-2710
Mailing Address - Fax:
Practice Address - Street 1:3429 LAWRENCEVILLE SUWANEE RD STE E-F
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2433
Practice Address - Country:US
Practice Address - Phone:678-400-2710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2022-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1228301223G0001X
ALD-0006788-C1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist