Provider Demographics
NPI:1932345246
Name:NGUYEN, TRI CUU (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRI
Middle Name:CUU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9061 BOLSA AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5558
Mailing Address - Country:US
Mailing Address - Phone:714-895-6557
Mailing Address - Fax:
Practice Address - Street 1:9061 BOLSA AVE
Practice Address - Street 2:STE 102
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5558
Practice Address - Country:US
Practice Address - Phone:714-895-6557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice