Provider Demographics
NPI:1962997965
Name:NGUYEN, DAVID LE (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LE
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 1:6428 BOYETT DR
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-3510
Mailing Address - Country:US
Mailing Address - Phone:404-468-2742
Mailing Address - Fax:
Practice Address - Street 1:5210 TOWN CENTER BLVD STE 310
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-3544
Practice Address - Country:US
Practice Address - Phone:470-508-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0156951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice