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Individual

CUONG PHU NGUYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
151 WESTCHESTER HALL, STONY BROOK, NY 11794-0001
(631) 444-2557
Mailing address
100 RONKONKOMA AVE APT 5E, RONKONKOMA, NY 11779-2792
(714) 232-3543

Taxonomy

Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
2901601178
MI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
01/19/2019
Last updated
01/06/2022
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