Provider Demographics
NPI:1649636242
Name:AFFORDABLE DENTURES - CANTON, VICTOR H. NGUYEN, DMD, INC.
Entity type:Organization
Organization Name:AFFORDABLE DENTURES - CANTON, VICTOR H. NGUYEN, DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD/PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-451-2205
Mailing Address - Street 1:2737 MARET ST NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-3909
Mailing Address - Country:US
Mailing Address - Phone:330-451-2205
Mailing Address - Fax:
Practice Address - Street 1:2737 MARET ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705-3909
Practice Address - Country:US
Practice Address - Phone:330-451-2205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023545122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty