Provider Demographics
NPI:1487703906
Name:NGUYEN, VU NGOC (DMD)
Entity type:Individual
Prefix:DR
First Name:VU
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WYNDHAM LN
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1186
Mailing Address - Country:US
Mailing Address - Phone:267-210-9673
Mailing Address - Fax:
Practice Address - Street 1:1381 E BOOT RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5988
Practice Address - Country:US
Practice Address - Phone:610-918-4995
Practice Address - Fax:610-918-6115
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037004122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist