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General NPI Number Information
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NPI Number | 1538444773
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Entity Type | Individual
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Provider Name | DUC TUAN HOANG DMD
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Gender | Male
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Dates
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Enumeration Date | 10/19/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 127 E MAIN ST # 131
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City | MIDDLETOWN
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State | NY
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Zip | 10940-5118
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Country | US
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Telephone | 845-342-5866
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 WAYNE AVE APT 8D
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City | BRONX
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State | NY
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Zip | 10467-2517
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Country | US
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Telephone | 817-781-8653
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Fax |
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 058969
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License Number State | NY
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