Individual
DR. SON VAN NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2065 ROCKBRIDGE RD, STONE MOUNTAIN, GA 30087-3513
(770) 469-9771
Mailing address
2065 ROCKBRIDGE RD, STONE MOUNTAIN, GA 30087-3513
(770) 469-9771
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012343
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000926901A
—
GA
05
—
100237
—
GA
05
—
108930
—
GA
Enumeration date
01/09/2007
Last updated
07/09/2007
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