Provider Demographics
NPI:1548487812
Name:NGO, FLORENCE PHUONG (DDS)
Entity type:Individual
Prefix:DR
First Name:FLORENCE
Middle Name:PHUONG
Last Name:NGO
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 1:18570 PROSPECT RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-3646
Mailing Address - Country:US
Mailing Address - Phone:408-873-7659
Mailing Address - Fax:408-873-7509
Practice Address - Street 1:18570 PROSPECT RD
Practice Address - Street 2:SUITE A
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-3646
Practice Address - Country:US
Practice Address - Phone:408-873-7659
Practice Address - Fax:408-873-7509
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47530122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist