MEDICARE: CDC ORTHODONTICS 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	18843	TX

General Provider Information

NPI Number	:	1891156188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CDC ORTHODONTICS PLLC

Provider Business Mailing Address
First Line	:	8900 FOREST LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75043
Country	:	US
Telephone Number	:	972-234-4500
Fax Number	:	972-234-4501

Provider Business Practice Location Address
First Line	:	8900 FOREST LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-4113
Country	:	US
Telephone Number	:	972-234-4500
Fax Number	:	972-234-4501

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANE HOANG
Credential	:
Telephone Number	:	972-234-4500

Provider Enumeration Date	:	03/14/2016
Last Update Date	:	03/14/2016

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