Individual
DR. PHUONG THAO TRAN NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MSD
Contact information
Practice address
2168 SKYVIEW DR, LITHIA SPRINGS, GA 30122-2638
(770) 739-5097
Mailing address
2168 SKYVIEW DR, LITHIA SPRINGS, GA 30122-2638
(832) 566-7358
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
6904
LA
1223P0300X
Periodontics
Primary
DN122278
GA
Other
Enumeration date
07/05/2018
Last updated
03/17/2023
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