Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | DN012723 | GA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 64391 | GA |
N | 207YS0123X | Facial Plastic Surgeon | 64391 | GA |
NPI | 1548446594 |
---|---|
Provider Name | Dr. Cang Huynh |
First Address | Atlanta, GA 30328-6141 |
Second Address | Atlanta, GA 30328-6141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2008 |
Last Update Date | 29/05/2014 |