Healthcare Provider Details

I. General information

NPI: 1033598073
Provider Name (Legal Business Name): DR. DAVID HOANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 SW 3RD ST STE B
OKLAHOMA CITY OK
73128-2209
US

IV. Provider business mailing address

6400 SW 3RD ST STE B
OKLAHOMA CITY OK
73128-2209
US

V. Phone/Fax

Practice location:
  • Phone: 405-698-3317
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6685
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: