# AVONDALE FAMILY DENTAL CARE PC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548387384
- **Authorized official:** NAM-RENE NGUYEN DDS (PRESIDENT)
- **Authorized official phone:** (623) 932-3344

## Contact information

- **Practice address:** 320 E WESTERN AVE, AVONDALE, AZ 85323-2348
- **Practice address phone:** (623) 932-3344
- **Practice address fax:** (623) 932-0594
- **Mailing address:** 320 E WESTERN AVE, AVONDALE, AZ 85323-2348
- **Mailing address phone:** (623) 932-3344
- **Mailing address fax:** (623) 932-0594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5074 | AZ | Yes |

## Other

- **Enumeration date:** 03/26/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 480476 | — | AZ |