Individual
LEAN NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3546 GRAVOIS AVE, SAINT LOUIS, MO 63118
(314) 773-3666
Mailing address
3546 GRAVOIS AVE, SAINT LOUIS, MO 63118
(314) 773-3666
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2003018141
MO
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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