Healthcare Provider Details

I. General information

NPI: 1477681880
Provider Name (Legal Business Name): AUSTIN T HOAN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7244 W COLONIAL DR
ORLANDO FL
32818-6749
US

IV. Provider business mailing address

1037 CRYSTAL BAY LN
ORLANDO FL
32828-6636
US

V. Phone/Fax

Practice location:
  • Phone: 407-299-6480
  • Fax:
Mailing address:
  • Phone: 407-952-0393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN15984
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: