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General NPI Number Information
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NPI Number | 1295803062
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Entity Type | Individual
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Provider Name | HAI DAI HOANG D.D.S
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1212 S.11TH ST. #47
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City | TACOMA
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State | WA
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Zip | 98405
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Country | US
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Telephone | 253-573-0070
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Fax | 253-573-0272
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Provider Business Mailing Address
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Address Line | 5601 NORPOINT WAY NE
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City | TACOMA
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State | WA
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Zip | 98422-1369
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Country | US
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Telephone | 253-927-7118
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Fax | 253-573-0272
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | WA00007972
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License Number State | WA
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