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Individual

HENRY CHUONG NGUYEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
1394 INDIAN TRAIL LILBURN RD, SUITE 301, NORCROSS, GA 30093-2677
(770) 921-9792
(770) 921-9009
Mailing address
1394 INDIAN TRAIL LILBURN RD, SUITE 301, NORCROSS, GA 30093-2677
(770) 921-9792
(770) 921-9009

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN011563
GA
1223G0001X
General Practice Dentistry
DN011563
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00714172A
GA
01
39100
AVESIS
GA
01
9180327
DORAL
GA
Enumeration date
07/18/2006
Last updated
07/05/2022
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