Individual
MAI PHUONG NGOC NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1148 BROADWAY STE 100, TACOMA, WA 98402-3518
(253) 268-1170
Mailing address
1148 BROADWAY STE 100, TACOMA, WA 98402-3518
(253) 268-1170
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60394732
WA
1223G0001X
General Practice Dentistry
28348
TX
Other
Enumeration date
09/20/2012
Last updated
01/07/2025
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