MEDICARE: DR. WALTER S. HONG D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	13307	MD

General Provider Information

NPI Number	:	1083617922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WALTER S. HONG D.D.S.

Provider Business Mailing Address
First Line	:	4330 MOUNTAIN RD
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-4520
Country	:	US
Telephone Number	:	410-255-8001
Fax Number	:	410-255-0687

Provider Business Practice Location Address
First Line	:	4330 MOUNTAIN RD
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-4520
Country	:	US
Telephone Number	:	410-255-8001
Fax Number	:	410-255-0687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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