Healthcare Provider Details

I. General information

NPI: 1053399550
Provider Name (Legal Business Name): HANLING HWANG JOSWICK DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 09/28/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48TH MDG UNIT 5115
APO AE
09461-5115
US

IV. Provider business mailing address

201 INDEPENDENCE
COLUMBUS MS
39710-5300
US

V. Phone/Fax

Practice location:
  • Phone: 850-400-3646
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8204
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: