Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN0012760 | FL |
NPI | 1720350572 |
---|---|
Provider Name | Dr. Huong Thien Nguyen |
First Address | Deland, FL 32724-5568 |
Second Address | Daytona Beach, FL 32117-5114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2012 |
Last Update Date | 16/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004550500 | (05) | FL |