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General NPI Number Information
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NPI Number | 1669651337
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Entity Type | Individual
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Provider Name | HOANG TRONG THAN D.D.S
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Gender | Male
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 7101 WYOMING ST
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City | WESTMINSTER
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State | CA
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Zip | 92683-3811
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Country | US
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Telephone | 714-893-3581
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Fax |
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Provider Business Mailing Address
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Address Line | 730 S TOURMALINE CT
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City | ANAHEIM
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State | CA
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Zip | 92807-4865
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Country | US
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Telephone | 714-916-1931
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 55035
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License Number State | CA
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