Healthcare Provider Details

I. General information

NPI: 1154874683
Provider Name (Legal Business Name): HUNG CONG TRUONG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2016
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2817 ROCK MERRITT AVE
FORT BRAGG NC
28310-0001
US

IV. Provider business mailing address

2817 ROCK MERRITT AVE ORAL MAXILLOFACIAL SURGERY DEPARTMENT
FORT BRAGG NC
28310-0001
US

V. Phone/Fax

Practice location:
  • Phone: 910-907-6974
  • Fax: 910-907-8035
Mailing address:
  • Phone: 910-907-6974
  • Fax: 910-907-8035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number11746
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: