Organization
DR. JACQUELINE B. NGUYEN, DDS, APC
Active
Other names
Evergreen Dentists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE B NGUYEN DDS (OWNER/PRESIDENT)
(408) 472-4749
Entity
Organization
Contact information
Practice address
2847 S WHITE RD STE 204, SAN JOSE, CA 95148-2942
(408) 238-8380
(408) 238-8404
Mailing address
2847 S WHITE RD STE 204, SAN JOSE, CA 95148-2942
(408) 238-8380
(408) 238-8404
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48969
DENTAL LICENSE
CA
Enumeration date
11/09/2018
Last updated
12/21/2018
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