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NPI Code Detail

MEDICARE: DR. PHUONG D. DOAN D.D.S.

MEDICARE:  DR. PHUONG D. DOAN  D.D.S.
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
11223P0700XProsthodontics049670NY

General Provider Information

NPI Number : 1942410204
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHUONG D. DOAN D.D.S.
Provider Business Mailing Address
First Line : 340 MADISON AVENUE, SUITE 4C
Second Line :
City : NEW YORK
State : NY
Zip : 10173-1909
Country : US
Telephone Number : 917-805-3628
Fax Number :
Provider Business Practice Location Address
First Line : 340 MADISON AVENUE, SUITE 4C
Second Line :
City : NEW YORK
State : NY
Zip : 10173-1909
Country : US
Telephone Number : 917-805-3628
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 01/28/2010

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Directions to “ DR. PHUONG D. DOAN D.D.S.” Practice Location

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