Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN188 | WA |
NPI | 1568683969 |
---|---|
Provider Name | Thu Van Nguyen |
First Address | Seattle, WA 98118-3592 |
Second Address | Seattle, WA 98118-3592 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |