Individual
AITAM DUONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10632 MORNINGSIDE DR, GARDEN GROVE, CA 92843-4903
(714) 603-9547
Mailing address
10632 MORNINGSIDE DR, GARDEN GROVE, CA 92843-4903
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105794
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2020
Last updated
11/24/2020
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