Organization
KINGSBURY ORAL AND MAXILLOFACIAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATINA NGUYEN DDS (PRESIDENT)
(909) 583-5356
Entity
Organization
Contact information
Practice address
1 PRESIDENTIAL BLVD STE 207, BALA CYNWYD, PA 19004-1007
(909) 583-5356
Mailing address
1401 SPRUCE ST APT 1905, PHILADELPHIA, PA 19102-4641
(909) 583-5356
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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