Healthcare Provider Details

I. General information

NPI: 1083990253
Provider Name (Legal Business Name): THOMAS HAO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 11/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29795 THREE NOTCH RD
CHARLOTTE HALL MD
20622-4106
US

IV. Provider business mailing address

29795 THREE NOTCH RD
CHARLOTTE HALL MD
20622-4106
US

V. Phone/Fax

Practice location:
  • Phone: 301-290-5666
  • Fax: 301-290-5886
Mailing address:
  • Phone: 301-290-5666
  • Fax: 301-290-5886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number13436
License Number StateMD

VIII. Authorized Official

Name: DR. THOMAS C HAO
Title or Position: OWNER/DOCTOR
Credential: D.D.S
Phone: 301-290-5666