Individual
DR. KELLY TRAM ANH NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5065 UNIVERSITY PKWY, WINSTON SALEM, NC 27106-6083
(336) 714-5726
Mailing address
5065 UNIVERSITY PKWY, WINSTON SALEM, NC 27106-6083
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11958
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2020
Last updated
10/08/2020
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