Individual
JACKSON NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1259 S WABASH AVE, CHICAGO, IL 60605-2412
(424) 212-3905
Mailing address
4961 GALLEON XING, DECATUR, GA 30035-3053
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.036312
IL
Other
Enumeration date
04/16/2025
Last updated
08/14/2025
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