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NPI Code Detail

MEDICARE: HAO RONG DDS INC

MEDICARE: HAO RONG DDS INC
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
11223G0001XGeneral Practice Dentistry60308CA

General Provider Information

NPI Number : 1295128585
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAO RONG DDS INC
Provider Business Mailing Address
First Line : 5150 GRAVES AVE STE 11A
Second Line :
City : SAN JOSE
State : CA
Zip : 95129-5014
Country : US
Telephone Number : 408-753-9955
Fax Number :
Provider Business Practice Location Address
First Line : 5150 GRAVES AVE STE 11A
Second Line :
City : SAN JOSE
State : CA
Zip : 95129-5014
Country : US
Telephone Number : 408-753-9955
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. HAO RONG
Credential : DDS
Telephone Number : 408-753-9955
Provider Enumeration Date : 03/10/2015
Last Update Date : 06/08/2016

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Directions to “HAO RONG DDS INC ” Practice Location

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