Individual
DR. KATINA NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1 PRESIDENTIAL BLVD, BALA CYNWYD, PA 19004-1017
(909) 582-5356
Mailing address
1 PRESIDENTIAL BLVD, BALA CYNWYD, PA 19004-1017
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
64068
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DDS64068
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS042139
PA
Other
Enumeration date
10/02/2014
Last updated
06/27/2019
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