Individual
DIANE HAO NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
969 WINDY HILL ROAD, SUITE J, SMYRNA, GA 30080
(770) 431-9578
(770) 438-2919
Mailing address
969 WINDY HILL ROAD, SUITE J, SMYRNA, GA 30080
(770) 431-9578
(770) 438-2919
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN012312
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000909235A
—
GA
01
—
100489
AVESIS GA MEDICAL DENTAL
GA
01
—
9180389
DORAL
GA
Enumeration date
08/11/2006
Last updated
07/09/2007
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