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Individual

DR. QUAN NGHIEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1510 DORCHESTER AVE, DORCHESTER, MA 02122-1327
(781) 288-7600
Mailing address
915 RANDOLPH ST, CANTON, MA 02021-1366
(781) 888-2415

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
22312
MA
1223G0001X
General Practice Dentistry
22312
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
46-4210597
MA
Enumeration date
09/21/2009
Last updated
04/20/2017
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