Individual
DEREK P NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8016 E GENESEE ST, FAYETTEVILLE, NY 13066-9692
(315) 637-6961
(315) 637-0169
Mailing address
11228 NE 134TH PL, VANCOUVER, WA 98682-2070
(360) 921-2187
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
056306
NY
Other
Enumeration date
05/03/2011
Last updated
07/14/2019
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