Provider Demographics
NPI:1285701250
Name:LA, HOANG TUAN HUY (DDS)
Entity type:Individual
Prefix:DR
First Name:HOANG TUAN
Middle Name:HUY
Last Name:LA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4616 W CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-5138
Mailing Address - Country:US
Mailing Address - Phone:559-738-1078
Mailing Address - Fax:559-738-1078
Practice Address - Street 1:828 S MOONEY BLVD
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-2212
Practice Address - Country:US
Practice Address - Phone:559-636-6040
Practice Address - Fax:559-636-8862
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44914122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist