Provider Demographics
NPI:1699967166
Name:PAULO THUAN NGUYEN DMD, PA
Entity type:Organization
Organization Name:PAULO THUAN NGUYEN DMD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-267-9527
Mailing Address - Street 1:100 W PIONEER PKWY
Mailing Address - Street 2:STE 106
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-6131
Mailing Address - Country:US
Mailing Address - Phone:817-265-9527
Mailing Address - Fax:817-299-9547
Practice Address - Street 1:100 W PIONEER PKWY
Practice Address - Street 2:STE 106
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-6131
Practice Address - Country:US
Practice Address - Phone:817-265-9527
Practice Address - Fax:817-299-9547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22331122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty