Provider Demographics
NPI:1841047065
Name:NGUYEN AND MONTILLA DDS PC INC
Entity type:Organization
Organization Name:NGUYEN AND MONTILLA DDS PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NGHI
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-299-5430
Mailing Address - Street 1:9545 RESEDA BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-2348
Mailing Address - Country:US
Mailing Address - Phone:818-886-6660
Mailing Address - Fax:818-886-6660
Practice Address - Street 1:9545 RESEDA BLVD STE 1
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-2348
Practice Address - Country:US
Practice Address - Phone:818-886-6660
Practice Address - Fax:818-886-6660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty