Provider Demographics
NPI:1154710341
Name:DR. INHWAN HONG, PC
Entity type:Organization
Organization Name:DR. INHWAN HONG, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:INHWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-531-2122
Mailing Address - Street 1:39 CROSS ST STE 102
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-1628
Mailing Address - Country:US
Mailing Address - Phone:978-531-2122
Mailing Address - Fax:978-532-3562
Practice Address - Street 1:39 CROSS ST STE 102
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1628
Practice Address - Country:US
Practice Address - Phone:978-531-2122
Practice Address - Fax:978-532-3562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18554101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty