| NPI | 1396252045 |
|---|---|
| Other Name | KENNY CONG NGUYEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 102236) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 34600) |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2020-11-09 |