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Organization
RANDY TRUNG-QUY NGUYEN, DDS A DENTAL CORPORATION
Active
Organization
RANDY TRUNG-QUY NGUYEN, DDS A DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY TRUNG-QUY NGUYEN DDS (PRESIDENT)
(707) 527-8700
Entity
Organization
Contact information
Practice address
526 COLLEGE AVE, SANTA ROSA, CA 95404-4103
(707) 527-8700
(707) 527-8134
Mailing address
526 COLLEGE AVE, SANTA ROSA, CA 95404-4103
(707) 527-8700
(707) 527-8134
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
43828
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861552812
NPI
CA
01
—
G89559-01
MEDI-CAL
CA
Enumeration date
02/23/2009
Last updated
02/23/2009
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