Provider Demographics
NPI:1194989855
Name:NGUYEN, MINH TRUNG (DMD)
Entity type:Individual
Prefix:DR
First Name:MINH
Middle Name:TRUNG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 LBJ FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2723
Mailing Address - Country:US
Mailing Address - Phone:972-444-8888
Mailing Address - Fax:972-243-6059
Practice Address - Street 1:3010 LBJ FWY STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-2723
Practice Address - Country:US
Practice Address - Phone:972-444-8888
Practice Address - Fax:972-243-6059
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice