Organization
SC DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD TUANHO NGUYEN DDS (PRESIDENT)
(714) 775-8434
Entity
Organization
Contact information
Practice address
9741 BOLSA AVE, SUITE 106, WESTMINSTER, CA 92683-6683
(714) 775-8434
(714) 775-1241
Mailing address
9741 BOLSA AVE, SUITE 106, WESTMINSTER, CA 92683-6683
(714) 775-8434
(714) 775-1241
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
52659
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
523992
DENTICAL PROVIDER NUMBER
CA
01
—
G89814-01
DENTICAL BILLING NUMBER
CA
Enumeration date
08/10/2007
Last updated
04/29/2008
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