Provider Demographics
NPI:1043350879
Name:NGUYEN, THANH-TRUC T (DDS)
Entity type:Individual
Prefix:DR
First Name:THANH-TRUC
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 SUNSET BLVD STE 119
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4784
Mailing Address - Country:US
Mailing Address - Phone:916-435-1155
Mailing Address - Fax:916-435-1152
Practice Address - Street 1:2221 SUNSET BLVD STE 119
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4784
Practice Address - Country:US
Practice Address - Phone:916-435-1155
Practice Address - Fax:916-435-1152
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA475371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice