Provider Demographics
NPI:1730601329
Name:NGUYEN, TUAN A Q (DMD)
Entity type:Individual
Prefix:
First Name:TUAN
Middle Name:A Q
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 W BRANDON BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5003
Mailing Address - Country:US
Mailing Address - Phone:813-381-5632
Mailing Address - Fax:
Practice Address - Street 1:511 W BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDO
Practice Address - State:FL
Practice Address - Zip Code:33511-5003
Practice Address - Country:US
Practice Address - Phone:813-381-5632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN228941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice