# KINGSBURY ORAL AND MAXILLOFACIAL SURGERY, PC

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

## Provider details

- **NPI number:** 1568074037
- **Authorized official:** DR. KATINA NGUYEN DDS (PRESIDENT)
- **Authorized official phone:** (909) 583-5356

## Contact information

- **Practice address:** 1 PRESIDENTIAL BLVD STE 207, BALA CYNWYD, PA 19004-1007
- **Practice address phone:** (909) 583-5356
- **Mailing address:** 1401 SPRUCE ST APT 1905, PHILADELPHIA, PA 19102-4641
- **Mailing address phone:** (909) 583-5356

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 08/17/2020
- **Last updated:** 08/17/2020