Individual
THANH NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
790 GLENWOOD AVE SE STE 210, ATLANTA, GA 30316-2024
(404) 260-4767
Mailing address
45 IVAN ALLEN JR BLVD NW UNIT 2307, ATLANTA, GA 30308-3061
(832) 351-0833
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN122308
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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