MEDICARE: MAILOAN THI HOANG DDS

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	122300000X	Dentist	41088	CA

General Provider Information

NPI Number	:	1669466967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAILOAN THI HOANG DDS

Provider Business Mailing Address
First Line	:	4514 W 1ST ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92703-3102
Country	:	US
Telephone Number	:	714-839-5533
Fax Number	:	714-839-2425

Provider Business Practice Location Address
First Line	:	4514 W 1ST ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92703-3102
Country	:	US
Telephone Number	:	714-839-5533
Fax Number	:	714-839-2425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	04/29/2016

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Directions to “ MAILOAN THI HOANG DDS” Practice Location

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