Provider Demographics
NPI:1558119057
Name:NGUYEN, MINH QUAN (RDH)
Entity type:Individual
Prefix:MR
First Name:MINH QUAN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 ABBEYGLEN CASTLE DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7463
Mailing Address - Country:US
Mailing Address - Phone:512-487-9287
Mailing Address - Fax:
Practice Address - Street 1:314 CHICON ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-4446
Practice Address - Country:US
Practice Address - Phone:512-978-8650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26030124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist