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Organization
QUAN VO ANH NGUYEN DDS INC
Active
Organization
QUAN VO ANH NGUYEN DDS INC
Active
Other names
Innovation Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QUAN VO ANH NGUYEN DDS (CEO/ MANAGING DENTIST)
(209) 478-9648
Entity
Organization
Contact information
Practice address
702 PORTER AVE STE F, STOCKTON, CA 95207-4297
(209) 478-9648
Mailing address
702 PORTER AVE STE F, STOCKTON, CA 95207-4297
(209) 478-9648
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
46658
CA
Other
Enumeration date
05/04/2012
Last updated
05/04/2012
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