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NPI Code Detail

MEDICARE: DANG KHOA P HOANG DMD

MEDICARE: DANG KHOA P HOANG DMD
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 DentistryD8150OR

General Provider Information

NPI Number : 1528155108
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANG KHOA P HOANG DMD
Provider Business Mailing Address
First Line : 2606 NE BROADWAY ST
Second Line : SUITE A
City : PORTLAND
State : OR
Zip : 97232-1721
Country : US
Telephone Number : 503-595-5463
Fax Number :
Provider Business Practice Location Address
First Line : 2606 NE BROADWAY ST
Second Line : SUITE A
City : PORTLAND
State : OR
Zip : 97232-1721
Country : US
Telephone Number : 503-595-5463
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 07/08/2007

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Directions to “ DANG KHOA P HOANG DMD” Practice Location

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