Individual
BRANDON NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
401 W BROADWAY ST, MONTICELLO, IN 47960-2004
(574) 583-5042
Mailing address
100 FOUNDRY DR APT 131, WEST LAFAYETTE, IN 47906-3462
(510) 575-9025
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013922A
IN
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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