Healthcare Provider Details

I. General information

NPI: 1588700090
Provider Name (Legal Business Name): TO-NGUYEN THI HOANG D.M.D., P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8190 JOG RD SUITE 240
BOYNTON BEACH FL
33437-2912
US

IV. Provider business mailing address

8190 JOG RD SUITE 240
BOYNTON BEACH FL
33437-2912
US

V. Phone/Fax

Practice location:
  • Phone: 561-732-8001
  • Fax: 561-732-8095
Mailing address:
  • Phone: 561-732-8001
  • Fax: 561-732-8095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN11999
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: