Healthcare Provider Details

I. General information

NPI: 1407600216
Provider Name (Legal Business Name): HOANG DMD & NGO DDS AND ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 S SYCAMORE ST
FREMONT NC
27830-8709
US

IV. Provider business mailing address

5005 GLENMORGAN LN
RALEIGH NC
27616-7418
US

V. Phone/Fax

Practice location:
  • Phone: 919-242-5500
  • Fax:
Mailing address:
  • Phone: 336-541-0208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BAO HOANG
Title or Position: OWNER
Credential: DMD
Phone: 336-541-0208