Individual
DR. DEREK NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
815 W 1ST ST STE B, JUSTIN, TX 76247-9663
(940) 222-2022
Mailing address
4009 BAMBERG LN, FORT WORTH, TX 76244-6051
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
39550
TX
Other
Enumeration date
03/28/2023
Last updated
06/21/2023
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