Healthcare Provider Details

I. General information

NPI: 1144574278
Provider Name (Legal Business Name): THUY TRAN THIEN HOANG D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2012
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 PARNASSUS AVE
SAN FRANCISCO CA
94143-2210
US

IV. Provider business mailing address

707 PARNASSUS AVE
SAN FRANCISCO CA
94143-2210
US

V. Phone/Fax

Practice location:
  • Phone: 949-391-6337
  • Fax:
Mailing address:
  • Phone: 949-391-6337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number61369
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: