Provider Demographics
NPI:1699053934
Name:NGUYEN, VICTOR (DMD)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
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 1:2737 MARET ST NE
Mailing Address - Street 2:PLEASANT VIEW COMMONS
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-3909
Mailing Address - Country:US
Mailing Address - Phone:330-451-2205
Mailing Address - Fax:330-451-2207
Practice Address - Street 1:2737 MARET ST NE
Practice Address - Street 2:PLEASANT VIEW COMMONS
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705-3909
Practice Address - Country:US
Practice Address - Phone:330-451-2205
Practice Address - Fax:330-451-2207
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice