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General NPI Number Information
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NPI Number | 1114167079
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Entity Type | Organization
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Legal Business Name | ALAFAYA DENTAL CARE
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Dates
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Enumeration Date | 03/04/2009
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Last Update Date | 03/04/2009
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Provider Practice Location Address
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Address Line | 2984 ALAFAYA TRL STE 2030
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City | OVIEDO
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State | FL
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Zip | 32765-7628
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Country | US
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Telephone | 407-366-8989
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Fax | 407-359-6381
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Provider Business Mailing Address
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Address Line | 2984 ALAFAYA TRL STE 2030
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City | OVIEDO
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State | FL
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Zip | 32765-7628
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Country | US
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Telephone | 407-366-8989
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Fax | 407-359-6381
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Authorized Official
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Title or Position | DENTIST/PRESIDENT
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Name | DR. AUSTIN THAI-HOA HOAN
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Credential | D.M.D.
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Telephone | 407-366-8989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN17157
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN15984
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License Number State | FL
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