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NPI Code Detail

MEDICARE: DR. DAN LE HOANG D.D.S.

MEDICARE: DR. DAN LE HOANG 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
11223G0001XGeneral Practice DentistryD12934MN

General Provider Information

NPI Number : 1740578533
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAN LE HOANG D.D.S.
Provider Business Mailing Address
First Line : 1286 129TH LN NW
Second Line :
City : COON RAPIDS
State : MN
Zip : 55448-1564
Country : US
Telephone Number : 763-464-1936
Fax Number :
Provider Business Practice Location Address
First Line : 11237 FOLEY BLVD NW
Second Line :
City : COON RAPIDS
State : MN
Zip : 55448-3389
Country : US
Telephone Number : 763-757-3120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2011
Last Update Date : 07/14/2011

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