Provider Demographics
NPI:1871784819
Name:NGUYEN, NHANQUYEN (DDS)
Entity type:Individual
Prefix:DR
First Name:NHANQUYEN
Middle Name:
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 1:1011 2ND ST N
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4616
Mailing Address - Country:US
Mailing Address - Phone:320-529-0910
Mailing Address - Fax:
Practice Address - Street 1:1011 2ND ST N
Practice Address - Street 2:SUITE 102
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4616
Practice Address - Country:US
Practice Address - Phone:320-529-0910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND111111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice