MEDICARE: DR. AUSTIN T HOAN D.M.D.

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	DN15984	FL

General Provider Information

NPI Number	:	1477681880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUSTIN T HOAN D.M.D.

Provider Business Mailing Address
First Line	:	1037 CRYSTAL BAY LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-6636
Country	:	US
Telephone Number	:	407-952-0393
Fax Number	:

Provider Business Practice Location Address
First Line	:	7244 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-6749
Country	:	US
Telephone Number	:	407-299-6480
Fax Number	:

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

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/08/2007

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