| Theresa M. Nguyenduc Dmd, Inc. | |
|
1202 Bristol St. Ste. #110 Costa Mesa CA 92626 | |
| (714) 979-8008 | |
| Not Available |
| Full Name | Theresa M. Nguyenduc Dmd, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1202 Bristol St., Costa Mesa, California |
| Authorized Official Name and Position | Theresa M Nguyenduc (PRESIDENT) |
| Authorized Official Contact | 7149798008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa M. Nguyenduc Dmd, Inc. 1202 Bristol St. Ste. #110 Costa Mesa CA 92626 Ph: (714) 979-8008 | Theresa M. Nguyenduc Dmd, Inc. 1202 Bristol St. Ste. #110 Costa Mesa CA 92626 Ph: (714) 979-8008 |
| NPI Number | 1710174586 |
|---|---|
| Provider Enumeration Date | 09/26/2007 |
| Last Update Date | 09/26/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710174586 | NPI | - | NPPES |
| B39853-01 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 39853 (California) | Primary |
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