Organization
29 PALMS DENTAL GROUP, AN NGUYEN DDS MS CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AN VAN NGUYEN DDS (CEO)
(760) 865-0544
Entity
Organization
Contact information
Practice address
73666 JOSHUA DR, TWENTYNINE PALMS, CA 92277-2572
(760) 865-0544
Mailing address
73666 JOSHUA DR, TWENTYNINE PALMS, CA 92277-2572
(760) 865-0544
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
07/19/2020
Last updated
07/27/2020
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