Provider Demographics
NPI:1811172554
Name:NGUYEN, TOAN M (DDS)
Entity type:Individual
Prefix:
First Name:TOAN
Middle Name:M
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 DESSAU RIDGE LN
Mailing Address - Street 2:# 604
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-2119
Mailing Address - Country:US
Mailing Address - Phone:512-251-3331
Mailing Address - Fax:
Practice Address - Street 1:1508 DESSAU RIDGE LN
Practice Address - Street 2:# 604
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-2119
Practice Address - Country:US
Practice Address - Phone:512-251-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist