Healthcare Provider Details
I. General information
NPI: 1609069731
Provider Name (Legal Business Name): HOA TRUONG DMD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/22/2007
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27131 ALISO CREEK RD STE 120
ALISO VIEJO CA
92656-3361
US
IV. Provider business mailing address
27131 ALISO CREEK RD STE 120
ALISO VIEJO CA
92656-3361
US
V. Phone/Fax
- Phone: 949-362-3668
- Fax: 949-362-4683
- Phone: 949-362-3668
- Fax: 949-362-4683
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HOA
VU
TRUONG
Title or Position: DMD, OWNER
Credential: DMD
Phone: 949-362-3668