MEDICARE: ALICE HOANG, DMD, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1316694524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALICE HOANG, DMD, PLLC

Provider Business Mailing Address
First Line	:	405 QUINCY ST APT 1B
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221-6396
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	47 PLAZA ST W
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3905
Country	:	US
Telephone Number	:	718-207-8305
Fax Number	:

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	DR. ALICE HOANG
Credential	:	DMD
Telephone Number	:	843-819-1947

Provider Enumeration Date	:	03/08/2022
Last Update Date	:	03/08/2022

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