Nguyen, Son Van

Nguyen, Son Van is an individual health care provider with primary practice located at 2065 Rockbridge Rd , Stone Mountain GA 30087-3513. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Nguyen, Son Van can be contacted via phone (770) 469-9771.

Contact Information

Primary practice address
2065 Rockbridge Rd Stone Mountain GA 30087-3513
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 012343 Georgia

Profile Details

NPI number 1225187214
LBN Legal business name Nguyen, Son Van
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225187214 NPPES
Georgia MEDICAID 000926901A
Georgia MEDICAID 100237
Georgia MEDICAID 108930

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