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General NPI Number Information
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NPI Number | 1548828221
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Entity Type | Organization
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Legal Business Name | HOANG, NGUYEN, & LU DENTAL CORP
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Dates
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Enumeration Date | 05/29/2019
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 9912 CARMEL MOUNTAIN RD STE B
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City | SAN DIEGO
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State | CA
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Zip | 92129-2808
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Country | US
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Telephone | 858-538-9182
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Fax |
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Provider Business Mailing Address
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Address Line | 9912 CARMEL MOUNTAIN RD STE B
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City | SAN DIEGO
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State | CA
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Zip | 92129-2808
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Country | US
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Telephone | 858-538-9182
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDY T HOANG
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Credential | DDS
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Telephone | 858-538-9182
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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 |
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License Number State |
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