MEDICARE: QIN HUANG 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
1	122300000X	Dentist	DS036593	PA

General Provider Information

NPI Number	:	1922164417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QIN HUANG DMD

Provider Business Mailing Address
First Line	:	331 W BOOT RD
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-1109
Country	:	US
Telephone Number	:	610-235-6789
Fax Number	:

Provider Business Practice Location Address
First Line	:	331 W BOOT RD
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-1109
Country	:	US
Telephone Number	:	610-918-1710
Fax Number	:

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

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	03/20/2015

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