Provider Demographics
NPI:1063558617
Name:WALTER S. HONG, D.D.S., P.A.
Entity type:Organization
Organization Name:WALTER S. HONG, D.D.S., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:S
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-255-8001
Mailing Address - Street 1:4330 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-4520
Mailing Address - Country:US
Mailing Address - Phone:410-255-8001
Mailing Address - Fax:410-255-0687
Practice Address - Street 1:4330 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-4520
Practice Address - Country:US
Practice Address - Phone:410-255-8001
Practice Address - Fax:410-255-0687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13307261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental