Provider Demographics
NPI:1215946017
Name:HONG, CUONG N (DMD)
Entity type:Individual
Prefix:DR
First Name:CUONG
Middle Name:N
Last Name:HONG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13119 SEATTLE HILL RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-3400
Mailing Address - Country:US
Mailing Address - Phone:254-258-2487
Mailing Address - Fax:
Practice Address - Street 1:13119 SEATTLE HILL RD
Practice Address - Street 2:SUITE 105
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-3400
Practice Address - Country:US
Practice Address - Phone:254-258-2487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8480122300000X
WADE00010912122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist