Individual
DR. THUAN NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
5342 S ARCHER AVE, CHICAGO, IL 60632
(773) 284-8540
Mailing address
2606 W 99TH ST, EVERGREEN PARK, IL 60805-3641
(347) 703-2299
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
021002625
IL
1223E0200X
Endodontics
DEN.00203390
CO
1223P0221X
Pediatric Dentistry
Primary
021002601
IL
1223P0221X
Pediatric Dentistry
12012141A
IN
1223P0221X
Pediatric Dentistry
DEN.00303390
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851627731
THUAN NGUYEN
IL
Enumeration date
10/27/2009
Last updated
07/20/2018
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