Individual
PHONG NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADT
Contact information
Practice address
1213 E FRANKLIN AVE, MINNEAPOLIS, MN 55404
(612) 872-8086
(612) 872-8547
Mailing address
1213 E FRANKLIN AVE, MINNEAPOLIS, MN 55404-2923
(612) 872-8086
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
H9909
MN
125J00000X
Dental Therapist
DT78
MN
125K00000X
Advanced Practice Dental Therapist
Primary
DT78
MN
Other
Enumeration date
03/10/2017
Last updated
03/28/2019
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