Provider Demographics
NPI:1891495958
Name:NGUYEN, HARRY (DDS)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:
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 1:7458 LOUIS PASTEUR DR APT 505
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4517
Mailing Address - Country:US
Mailing Address - Phone:210-952-2242
Mailing Address - Fax:
Practice Address - Street 1:1119 W FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-5663
Practice Address - Country:US
Practice Address - Phone:507-774-3075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-10262122300000X
MND15171122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist