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General NPI Number Information
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NPI Number | 1760841860
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Entity Type | Organization
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Legal Business Name | ERICKSON AND HONG ORTHODONTICS, PC
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Dates
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Enumeration Date | 02/17/2016
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Last Update Date | 02/17/2016
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Provider Practice Location Address
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Address Line | 13321 NEW HAMPSHIRE AVE STE 206
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City | SILVER SPRING
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State | MD
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Zip | 20904-3450
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Country | US
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Telephone | 301-236-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 13321 NEW HAMPSHIRE AVE STE 206
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City | SILVER SPRING
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State | MD
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Zip | 20904-3450
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Country | US
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Telephone | 301-236-0600
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST/OWNER
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Name | DR. JEAN HONG
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Credential | DDS, MS
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Telephone | 301-236-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | MD 14419
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | MD 7215
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License Number State | MD
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