| NPI | 1477110302 |
|---|---|
| Former Name | TIFFANY THANH NGUYEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 00203988) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 61421) |
| 1223G0001X Dentist, General Practice (Licence: CO 00203988) | |
| Enumeration Date | 2019-05-27 |
| Last Update Date | 2022-10-01 |